title: Effects of mycophenolate mofetil introduction in liver transplant patients: results from an observational, non-interventional, multicenter study (LOBSTER).
abstract: The benefits of calcineurin inhibitor (CNI)-sparing regimens on renal function following liver transplantation (LT) have been demonstrated in clinical studies. This observational study assessed the real-life effects of mycophenolate mofetil (MMF) introduction in LT patients. Four hundred and ninety-seven patients in whom MMF was introduced according to local standards or clinical considerations were entered. Patients were grouped by time between transplantation and start of MMF (start of study): Group A (n = 263): ≤6 d; Group B (n = 64): >6 d to ≤1 month; Group C (n = 74): >1 month to ≤1 yr; and Group D (n = 96): >1 yr. CNI sparing occurred in all groups, particularly in Groups C and D. Mean MMF doses at 12 months were 1202.7, 1363.5, 1504.7, and 1578.1 mg/d, respectively, in Groups A-D. At introduction of MMF, median glomerular filtration rate was 73.3, 81.7, 62.7, and 53.7 mL/min/1.73 m(2) in Groups A-D. At 12 months, this decreased to 66 mL/min/1.73 m(2) in Groups A and B, remained stable in Group C, and increased in Group D (64.8 mL/min/1.73 m(2) ). Serious adverse drug reactions were lowest in Group D. In conclusion, MMF with a subsequent decrease in CNI was well tolerated and improved renal function even years after transplantation. A more forceful MMF dosing strategy with greater CNI sparing may further improve renal function.
authors: Department of Surgery, University of Regensburg, Regensburg, Germany.
authors: Hans J
authors: HJ
authors: Schlitt
authors: Sven
authors: S
authors: Jonas
authors: Tom M
authors: TM
authors: Ganten
authors: Gerrit
authors: G
authors: Grannas
authors: Christian
authors: C
authors: Moench
authors: Falk
authors: F
authors: Rauchfuss
authors: Aiman
authors: A
authors: Obed
authors: Giuseppe
authors: G
authors: Tisone
authors: Antonio D
authors: AD
authors: Pinna
authors: Giorgio E
authors: GE
authors: Gerunda
authors: Susanne
authors: S
authors: Beckebaum
mesh_terms: D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011379:Prognosis; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid