Intravenous mycophenolate mofetil with low-dose oral tacrolimus and steroid induction for live donor liver transplantation.

Ashokkumar Jain, Ravi Mohanka, Mark Orloff, Peter Abt, Randeep Kashyap, Mark Kelley, Kari Burlee, Adel Bozorgzadeh

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: Mycophenolate mofetil (MMF) is used in liver transplantation (LTx) to reduce rejection, nephrotoxicity, neurotoxicity, and the need for steroids. Lower trough concentrations and bioavailability have been reported with oral MMF in first week after LTx. These parameters improve after the first month postoperatively. Previously published studies have used oral formulations of MMF. In this study, we sought to examine survival, rejection, and nephrotoxicity rates using IV MMF in live donor liver transplantation (LDLT). PATIENTS AND METHODS: Twenty-eight patients (mean age, 50.1 years; 15 men, 13 women) were examined between January 2000 and January 2004 with a mean follow-up of 17 months for survival, rejection, and renal function. RESULTS: Four patients died at 2, 5, 8, and 18 months after LDLT from sepsis (n = 3) and recurrent hepatocellular carcinoma (n = 1). There were no retransplants; hence, patient and graft survival rates were the same (82.4%). Three patients (10.7%) experienced acute cellular rejection requiring treatment. The mean serum creatinine level prior to LDLT was 0.9 +/- 0.4 mg/dL, which remained stable throughout the study. One patient required hemodialysis during the perioperative period for 8 days. CONCLUSIONS: In the current study, we demonstrate a new strategy of IV MMF administration with low-dose tacrolimus that provides for lower rates of acute rejection, better preservation of renal function, and one that is better tolerated compared with historical treatments after LTx.

Original languageEnglish (US)
Pages (from-to)361-365
Number of pages5
JournalExperimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
Volume3
Issue number2
StatePublished - Jan 1 2005

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Mycophenolic Acid
Tacrolimus
Liver Transplantation
Steroids
Tissue Donors
Kidney
Perioperative Period
Survival
Graft Survival
Biological Availability
Renal Dialysis
Hepatocellular Carcinoma
Creatinine
Sepsis
Survival Rate
Therapeutics
Serum

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

@article{8192dc1e6a784776be6fa43000ec9edd,
title = "Intravenous mycophenolate mofetil with low-dose oral tacrolimus and steroid induction for live donor liver transplantation.",
abstract = "OBJECTIVES: Mycophenolate mofetil (MMF) is used in liver transplantation (LTx) to reduce rejection, nephrotoxicity, neurotoxicity, and the need for steroids. Lower trough concentrations and bioavailability have been reported with oral MMF in first week after LTx. These parameters improve after the first month postoperatively. Previously published studies have used oral formulations of MMF. In this study, we sought to examine survival, rejection, and nephrotoxicity rates using IV MMF in live donor liver transplantation (LDLT). PATIENTS AND METHODS: Twenty-eight patients (mean age, 50.1 years; 15 men, 13 women) were examined between January 2000 and January 2004 with a mean follow-up of 17 months for survival, rejection, and renal function. RESULTS: Four patients died at 2, 5, 8, and 18 months after LDLT from sepsis (n = 3) and recurrent hepatocellular carcinoma (n = 1). There were no retransplants; hence, patient and graft survival rates were the same (82.4{\%}). Three patients (10.7{\%}) experienced acute cellular rejection requiring treatment. The mean serum creatinine level prior to LDLT was 0.9 +/- 0.4 mg/dL, which remained stable throughout the study. One patient required hemodialysis during the perioperative period for 8 days. CONCLUSIONS: In the current study, we demonstrate a new strategy of IV MMF administration with low-dose tacrolimus that provides for lower rates of acute rejection, better preservation of renal function, and one that is better tolerated compared with historical treatments after LTx.",
author = "Ashokkumar Jain and Ravi Mohanka and Mark Orloff and Peter Abt and Randeep Kashyap and Mark Kelley and Kari Burlee and Adel Bozorgzadeh",
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Intravenous mycophenolate mofetil with low-dose oral tacrolimus and steroid induction for live donor liver transplantation. / Jain, Ashokkumar; Mohanka, Ravi; Orloff, Mark; Abt, Peter; Kashyap, Randeep; Kelley, Mark; Burlee, Kari; Bozorgzadeh, Adel.

In: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, Vol. 3, No. 2, 01.01.2005, p. 361-365.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intravenous mycophenolate mofetil with low-dose oral tacrolimus and steroid induction for live donor liver transplantation.

AU - Jain, Ashokkumar

AU - Mohanka, Ravi

AU - Orloff, Mark

AU - Abt, Peter

AU - Kashyap, Randeep

AU - Kelley, Mark

AU - Burlee, Kari

AU - Bozorgzadeh, Adel

PY - 2005/1/1

Y1 - 2005/1/1

N2 - OBJECTIVES: Mycophenolate mofetil (MMF) is used in liver transplantation (LTx) to reduce rejection, nephrotoxicity, neurotoxicity, and the need for steroids. Lower trough concentrations and bioavailability have been reported with oral MMF in first week after LTx. These parameters improve after the first month postoperatively. Previously published studies have used oral formulations of MMF. In this study, we sought to examine survival, rejection, and nephrotoxicity rates using IV MMF in live donor liver transplantation (LDLT). PATIENTS AND METHODS: Twenty-eight patients (mean age, 50.1 years; 15 men, 13 women) were examined between January 2000 and January 2004 with a mean follow-up of 17 months for survival, rejection, and renal function. RESULTS: Four patients died at 2, 5, 8, and 18 months after LDLT from sepsis (n = 3) and recurrent hepatocellular carcinoma (n = 1). There were no retransplants; hence, patient and graft survival rates were the same (82.4%). Three patients (10.7%) experienced acute cellular rejection requiring treatment. The mean serum creatinine level prior to LDLT was 0.9 +/- 0.4 mg/dL, which remained stable throughout the study. One patient required hemodialysis during the perioperative period for 8 days. CONCLUSIONS: In the current study, we demonstrate a new strategy of IV MMF administration with low-dose tacrolimus that provides for lower rates of acute rejection, better preservation of renal function, and one that is better tolerated compared with historical treatments after LTx.

AB - OBJECTIVES: Mycophenolate mofetil (MMF) is used in liver transplantation (LTx) to reduce rejection, nephrotoxicity, neurotoxicity, and the need for steroids. Lower trough concentrations and bioavailability have been reported with oral MMF in first week after LTx. These parameters improve after the first month postoperatively. Previously published studies have used oral formulations of MMF. In this study, we sought to examine survival, rejection, and nephrotoxicity rates using IV MMF in live donor liver transplantation (LDLT). PATIENTS AND METHODS: Twenty-eight patients (mean age, 50.1 years; 15 men, 13 women) were examined between January 2000 and January 2004 with a mean follow-up of 17 months for survival, rejection, and renal function. RESULTS: Four patients died at 2, 5, 8, and 18 months after LDLT from sepsis (n = 3) and recurrent hepatocellular carcinoma (n = 1). There were no retransplants; hence, patient and graft survival rates were the same (82.4%). Three patients (10.7%) experienced acute cellular rejection requiring treatment. The mean serum creatinine level prior to LDLT was 0.9 +/- 0.4 mg/dL, which remained stable throughout the study. One patient required hemodialysis during the perioperative period for 8 days. CONCLUSIONS: In the current study, we demonstrate a new strategy of IV MMF administration with low-dose tacrolimus that provides for lower rates of acute rejection, better preservation of renal function, and one that is better tolerated compared with historical treatments after LTx.

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