title: Efficacy and safety of mycophenolate mofetil as part of induction therapy in liver transplantation.
abstract: OBJECTIVE
  To report our experience with mycophenolate mofetil (MMF) for induction and maintenance therapy to prevent acute liver transplant rejection.
  
  
  METHODS
  A retrospective analysis of 66 elective, noncombined liver transplant patients treated beginning de novo MMF and follow for a minimum of 2 years. Thirty-nine of the 66 cases received MMF, calcineurin inhibitors, and steroids. In 11 cases daclizumab was added; in 16 daclizumab was added without steroids.
  
  
  RESULTS
  The global survival rate was 91% at 6 months, 89.4% at 1 year, and 87.9% after 2 years. Acute rejection episodes were observed in six patients (9.1%). All episodes responded to corticoids. Toxicity possibly, probably, or partially related to MMF was observed in 35 patients (53%) with definitive suspension required in 13 cases (20%), with dose reduction or temporary suspension in 22 (33%). Hematological toxicity associated with MMF was observed in 12 patients (18%), leading to definitive suspension in two patients (3.03%), temporary suspension in two cases (3.03%), and dose reduction in eight cases (12%). Opportunistic infection was observed in seven cases (10%). Gastrointestinal toxicity was mild and infrequent (five cases, 7.5%).
  
  
  CONCLUSIONS
  Regimens containing MMF reduce rejection episodes with high survival rates and low toxicity.
authors.affiliation: Hepatobiliary and Pancreatic Surgery and Liver Transplantation Unit, Virgen del Rocío Hospital, Seville, Spain. Felipe.Pareja@terra.es
authors.forename: F
authors.initials: F
authors.lastname: Pareja-Ciuró
authors.forename: J Serrano
authors.initials: JS
authors.lastname: Díez-Canedo
authors.forename: M A
authors.initials: MA
authors.lastname: Gómez-Bravo
authors.forename: I
authors.initials: I
authors.lastname: García-Gonzalez
authors.forename: M J
authors.initials: MJ
authors.lastname: Tamayo-López
authors.forename: J M
authors.initials: JM
authors.lastname: Sousa-Martín
authors.forename: J M
authors.initials: JM
authors.lastname: Pascasio-Acevedo
authors.forename: M F
authors.initials: MF
authors.lastname: Porras-Lopez
authors.forename: F
authors.initials: F
authors.lastname: Gavilán-Carrasco
authors.forename: A
authors.initials: A
authors.lastname: Bernardos-Rodríguez
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008107:Liver Diseases / Q000145:classification / Q000601:surgery*; D016031:Liver Transplantation / Q000276:immunology*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D012449:Safety; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid