title: Everolimus and enteric-coated mycophenolate sodium ab initio after liver transplantation: midterm results.
abstract: OBJECTIVE
  Everolimus (EVR) use in liver transplantation (OLT) has been prescribed with calcineurin inhibitors (CNIs), steroids, and monoclonal antibodies. The aim of our study was to evaluate the safety, feasibility, and impact on renal function of EVR ab initio, in combination with enteric-coated mycophenolate sodium (EC-MPS) without the use of induction treatment, steroids, or CNIs.
  
  
  METHODS
  We retrospective analyzed nine consecutive patients who underwent OLT at our institution. The initial dose of EVR (1.5 mg/d) was adjusted to achieve trough levels of 8 to 12 ng/mL. EC-MPS introduced at 1080 mg/d was maintained at the same dose over time.
  
  
  RESULTS
  At a mean follow-up of 21.48 (standard deviation [SD] 1.4) months from OLT, 7/9 recipients were alive with stable graft function. The 2-year patient and graft survivals were 77%. One recipient died due to cerebral hemorrhage and one, lung failure. No clinical evidence of an acute rejection episode was observed. Mean estimated glomerular filtration rate value, according to the Modification of Diet in Renal Disease formula increased from 59.5 (SD 9.89) mL/min/1.73 m(2) at OLT to 100.2 (SD 47.5) mL/min/1.73 m(2) (P = .03) after 12 months and 98.71 (SD 33.74) mL/min/1.73 m(2) (P = .03) after 24 months' follow-up.
  
  
  CONCLUSIONS
  A double immunosuppression therapy with EVR and EC-MPS ab initio seemed to be efficacions and safe, representing a valid alternative to CNIs to prevent renal failure after OLT.
authors.affiliation: Transplant Unit, Fondazione Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy.
authors.forename: T M
authors.initials: TM
authors.lastname: Manzia
authors.forename: D
authors.initials: D
authors.lastname: Sforza
authors.forename: R
authors.initials: R
authors.lastname: Angelico
authors.forename: M I
authors.initials: MI
authors.lastname: Bellini
authors.forename: P
authors.initials: P
authors.lastname: Ciano
authors.forename: M
authors.initials: M
authors.lastname: Manuelli
authors.forename: L
authors.initials: L
authors.lastname: Toti
authors.forename: G
authors.initials: G
authors.lastname: Tisone
mesh_terms: D000328:Adult; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D009173:Mycophenolic Acid; D020123:Sirolimus