Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients.
The aim of this study was to evaluate the impact of a steroid-free regimen with tacrolimus and mycophenolate mofetil (modified therapy) vs. a standard regimen of tacrolimus and steroids on the cardiovascular risk score of liver transplant recipients. Patients who received a liver transplant were randomized to a modified therapy (n = 58) or a standard regimen (n = 59). Both groups were balanced at baseline, except for a higher prevalence of diabetes mellitus (DM) (p < 0.01) and a higher serum creatinine concentration (p < 0.05) in the modified therapy group. After 12 months, the prevalence of new-onset DM, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, and changes in cardiovascular risk factors was similar in both groups. The increase in serum creatinine (mg/dL) compared to baseline at one yr post-transplantation was numerically lower in the modified therapy group (0.22 ± 0.42) than in the standard regimen group (0.41 ± 0.67) (p = 0.068). Although estimated cardiovascular risk score did not vary significantly compared to baseline in either group, there was a slight reduction in the modified regimen (-0.27 ± 2.87) vs. a mild increase (0.17 ± 2.94) in the standard regimen (p = 0.566). In conclusion, a steroid-free regimen with tacrolimus and mycophenolate mofetil was associated with a trend toward better preservation of kidney function and reduction of cardiovascular risk score.
Department of Internal Medicine, Liver Transplant Unit, Hospital Puerta de Hierro, Madrid, Spain.
Valentín
V
Cuervas-Mons
Liver Unit, Clínica Universitaria de Navarra, Pamplona, Spain.|CIBERehd (Centro de Investigación Biomédica en Red), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
J Ignacio
JI
Herrero
Hepatobiliopancreatic Surgery and Transplantation Unit, Hospital Virgen del Rocío, Sevilla, Spain.
Miguel A
MA
Gomez
Liver Transplantation Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.
Ignacio
I
González-Pinto
Hospital Lozano Blesa, Zaragoza, Spain.
Trinidad
T
Serrano
CIBERehd (Centro de Investigación Biomédica en Red), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.|Clinical Management Unit of Digestive System, Hepatology Section, Hospital Universitario Reina Sofía, Córdoba, Spain.
Manuel
M
de la Mata
Hepatobiliopancreatic Surgery and Liver Transplantation Unit, Hospital Universitari de Bellvitge, Barcelona, Spain.
Joan
J
Fabregat
Hospital Cruces, Bilbao, Spain.
Mikel
M
Gastaca
CIBERehd (Centro de Investigación Biomédica en Red), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.|Service of Hepatobiliopancreatic Surgery and Liver Transplantation, Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
Itxarone
I
Bilbao
Abdominal Transplantation Unit, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
Evaristo
E
Varo
Liver Transplant Unit, Hospital Universitario Río Hortega, Valladolid, Spain.
Gloria
G
Sánchez-Antolín
Hepatology and Liver Transplantation Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.
Juan
J
Rodrigo
Hepatology and Liver Transplantation Unit, Service of Digestive System, Hospitales Universitarios de Granada, Granada, Spain.
María Dolores
MD
Espinosa
D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008107:Liver Diseases / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use*; D016559:Tacrolimus / Q000627:therapeutic use*; D055815:Young Adult
D007166:Immunosuppressive Agents; D013256:Steroids; D009173:Mycophenolic Acid; D016559:Tacrolimus
cardiovascular risk factors; immunosuppression; liver transplantation; mycophenolate mofetil; steroids; tacrolimus