Early Initiation of Everolimus After Liver Transplantation: A Single-Center Experience
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Early Initiation of Everolimus After Liver Transplantation: A Single-Center Experience. / Herden, Uta; Galante, Antonio; Fischer, Lutz; Pischke, Sven; Li, Jun; Achilles, Eike; Koch, Martina; Nashan, Bjoern; Sterneck, Martina.
In: ANN TRANSPL, Vol. 21, 04.02.2016, p. 77-85.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Early Initiation of Everolimus After Liver Transplantation: A Single-Center Experience
AU - Herden, Uta
AU - Galante, Antonio
AU - Fischer, Lutz
AU - Pischke, Sven
AU - Li, Jun
AU - Achilles, Eike
AU - Koch, Martina
AU - Nashan, Bjoern
AU - Sterneck, Martina
PY - 2016/2/4
Y1 - 2016/2/4
N2 - BACKGROUND: Evidence relating to early everolimus use after liver transplantation remains limited.MATERIAL AND METHODS: Ninety-one adult patients undergoing liver transplantation at our center during 2007-2012 in whom everolimus therapy was initiated <3 months post-transplant were analyzed retrospectively. Everolimus was started on days 1-5 in 50 patients (group 1) and after day 5 in 41 patients (group 2). Most patients continued to receive low-dose cyclosporine (59.3%, target 50-80 ng/ml) or low-dose tacrolimus (25.3%; target 3-5 ng/ml). Mean follow-up was 4.6 years.RESULTS: One-, three- and five-year patient survival rates were 80.5%, 74.2%, and 70.5%, respectively, and did not differ between groups 1 and 2. Six patients (6.6%) developed biopsy-proven acute rejection after a median of 47 days (range 27-356 days). Everolimus was discontinued due to adverse events in 21 patients (23.1%). Incisional hernia repair occurred in 14.0% and 9.4% of patients in group 1 and 2, respectively. Renal function remained stable during follow-up, despite poor baseline function.CONCLUSIONS: Everolimus with very low-dose calcineurin inhibitor given immediately after liver transplantation appears safe and effective, achieving a low rejection rate with well-preserved renal function.
AB - BACKGROUND: Evidence relating to early everolimus use after liver transplantation remains limited.MATERIAL AND METHODS: Ninety-one adult patients undergoing liver transplantation at our center during 2007-2012 in whom everolimus therapy was initiated <3 months post-transplant were analyzed retrospectively. Everolimus was started on days 1-5 in 50 patients (group 1) and after day 5 in 41 patients (group 2). Most patients continued to receive low-dose cyclosporine (59.3%, target 50-80 ng/ml) or low-dose tacrolimus (25.3%; target 3-5 ng/ml). Mean follow-up was 4.6 years.RESULTS: One-, three- and five-year patient survival rates were 80.5%, 74.2%, and 70.5%, respectively, and did not differ between groups 1 and 2. Six patients (6.6%) developed biopsy-proven acute rejection after a median of 47 days (range 27-356 days). Everolimus was discontinued due to adverse events in 21 patients (23.1%). Incisional hernia repair occurred in 14.0% and 9.4% of patients in group 1 and 2, respectively. Renal function remained stable during follow-up, despite poor baseline function.CONCLUSIONS: Everolimus with very low-dose calcineurin inhibitor given immediately after liver transplantation appears safe and effective, achieving a low rejection rate with well-preserved renal function.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Cyclosporine
KW - Drug Administration Schedule
KW - Drug Therapy, Combination
KW - Everolimus
KW - Female
KW - Follow-Up Studies
KW - Graft Rejection
KW - Humans
KW - Immunosuppressive Agents
KW - Liver Transplantation
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Tacrolimus
KW - Treatment Outcome
KW - Young Adult
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.12659/AOT.895800
DO - 10.12659/AOT.895800
M3 - SCORING: Journal article
C2 - 26842532
VL - 21
SP - 77
EP - 85
JO - ANN TRANSPL
JF - ANN TRANSPL
SN - 1425-9524
ER -