Effects of everolimus monotherapy on hematological parameters and iron homeostasis in de novo liver transplant recipients: preliminary results.
BACKGROUND
Anemia after orthotopic liver transplantation (OLT) is a common complication due to several reasons. Immunosuppressive drugs play an important role in anemia occurring at 1 month or more after OLT. Several studies describe myelosuppression immunosuppressants such as the mammalian target of rapamycin inhibitors.


METHODS
We performed a single-center, prospective trial consisting of a short 30-day course of cyclosporine (CsA) associated with everolimus (EVL) from postoperative day 10 (Group EVL) versus a CsA immunosuppressive regimen (Group CsA) in de novo OLT patients. We explored the influence of immunosuppressive drugs on hematological parameters comparing EVL versus CsA.


RESULTS
Twenty-eight patients were enrolled in the EVL and 12 in the CsA Groups. After OLT, hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), white blood cell (WBC), platelets (PLT), transferrin saturation (TSAT), iron, ferritin, and transferrin did not differ significantly between the 2 groups at any time point. Among the patients who reached 6-months of follow-up, 5 (41.7%) EVL and 4 (80%) CsA subjects were anemic (P=not significant [NS]). Only anemia in patients enrolled in Group EVL showed a trend toward the features of microcytic, hypochromic anemia.


CONCLUSIONS
Our results demonstrated that de novo anemia in OLT patients treated with EVL monotherapy showed the same incidence as in patients treated with CsA. Hb values remained similar during the entire follow-up. Moreover, overall myelosuppression in the EVL Group was not significantly different from patients in the CsA Group.
Masetti
M
M
Liver and Multivisceral Transplant Center, University of Modena, Modena, Italy. masetti.michele@unimo.it
Rompianesi
G
G
Montalti
R
R
Romano
A
A
Spaggiari
M
M
Ballarin
R
R
Guerrini
G P
GP
Gerunda
G E
GE
D000740:Anemia / Q000139:chemically induced; D001810:Blood Volume / Q000187:drug effects; D016572:Cyclosporine / Q000627:therapeutic use; D000068338:Everolimus; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D007501:Iron / Q000378:metabolism*; D007958:Leukocyte Count; D016031:Liver Transplantation / Q000276:immunology*; D010976:Platelet Count; D011446:Prospective Studies; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D006454:Hemoglobins; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000068338:Everolimus; D007501:Iron; D020123:Sirolimus