title: Efficacy of minimal dosage of calcineurin inhibitor for living donor liver transplant recipients with preoperative renal dysfunction.
abstract: OBJECTIVE
  There is no standard protocol for immunosuppression for patients with preoperative chronic renal dysfunction (PCRD) scheduled for living donor liver transplantation (LDLT). In this prospective study, we evaluated the efficacy oflow-dose calcineurin inhibitor (CNI) protocol for such patients.
  
  
  METHODS
  We studied 17 consecutive LDLT recipients with PCRD (creatinine clearance <50 mL/min). Six patients (LD-B group) received combination of low-dose CNI (LD-CNI), mycophenolate mofetil, corticosteroids, and anti-CD25 monoclonal antibody (mAb). Their clinical data were compared with conventional CNI group (N group, n=8) and LD-CNI without CD25 mAb group (LD group, n=3).
  
  
  RESULTS
  Preoperative characteristics and incidence of acute rejection were similar in the three groups. None of the LD-B group recipients developed renal failure, while one (9%) did in the N group. Patient survival was better in the LD-B group than control groups.
  
  
  CONCLUSIONS
  Our renal sparing protocol is feasible and effective for LDLT recipients with PCRD.
authors.affiliation: Department of Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. smarubashi@gesurg.med.osaka-u.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Shogo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000328:Adult; D065095:Calcineurin Inhibitors; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007668:Kidney / Q000187:drug effects*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents