title: The influence of immunosuppression switching in liver function in adult hepatic transplantation.
abstract: We evaluate the 5-year results of a single-centre prospective randomized trial that compared cyclosporine microemulsion (CyA-me) in triple therapy (plus steroids and azathioprine) and Tacrolimus (Tac) in double therapy (plus steroids) for primary immunosuppression. One hundred adult patients undergoing liver transplantation were randomized to receive Tac (n=51) or CyA-me (n=49). Ten patients in group A, and thirty-one patients in group B had their main immunosuppressive agent switched. The switch was much more frequent from CyA-me to Tac (n=31; 62.3%), mainly because of lack of efficacy (n=12; 38.7%). Six of 10 patients were shifted from Tac to CyA-me for side effects. The clinical course of the majority of patients converted from CyA-me to Tac improved clearly after conversion. Donor age and acute rejection (number, severity and rejection free days) had a significative association with lack of efficacy in group B. In these series, the conversion to Tac from CyA-me could be accomplished safely, with an excellent long-term outcome.
authors.affiliation: University Hospital "12 de Octubre", Liver Transplantation Unit, Spain. marinlm@hotmail.com
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Marín Gómez
authors.forename: Carmelo
authors.initials: C
authors.lastname: Loinaz Segurota
authors.forename: Enrique
authors.initials: E
authors.lastname: Moreno González
authors.forename: Almudena
authors.initials: A
authors.lastname: Moreno Elola-Olaso
authors.forename: Ignacio
authors.initials: I
authors.lastname: González-Pinto Arrillaga
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Meneu Díaz
authors.forename: Manuel
authors.initials: M
authors.lastname: Abradelo de Usera
authors.forename: Ramón
authors.initials: R
authors.lastname: Gómez Sanz
authors.forename: Carlos
authors.initials: C
authors.lastname: Jiménez Romero
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: García Ureña
authors.forename: Vicente
authors.initials: V
authors.lastname: Vega Ruiz
mesh_terms: D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008099:Liver / Q000503:physiopathology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016559:Tacrolimus / Q000008:administration & dosage
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D016559:Tacrolimus