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Calcineurin inhibitor sparing with mycophenolate mofetil in liver transplantion: a systematic review of randomized controlled trials.
Goralczyk, A D; Bari, N; Abu-Ajaj, W; Lorf, T; Ramadori, G; Friede, T; Obed, A.
Afiliación
  • Goralczyk AD; University Medical Center Göttingen, Göttingen, Germany. agoralczyk@med.uni-goettingen.de
Am J Transplant ; 12(10): 2601-7, 2012 Oct.
Article en En | MEDLINE | ID: mdl-22813081
Liver transplant recipients are at high risk of developing acute and chronic renal failure. Moreover, introduction of the model for end-stage liver disease (MELD) score for primary allocation of liver grafts favors patients with pretransplant kidney dysfunction, which in turn have a higher risk of posttransplant renal failure. Calcineurin inhibitors (CNI) further increase the risk of renal failure and therefore sparing CNI with the use of mycophenolate mofetil (MMF) may improve renal function. MMF may either be used de novo in the immediate posttransplant period in combination with low-dose CNI (scenario 1) or patients that receive immunosuppression based on CNI may be converted to MMF in combination with minimization or elimination of CNI (scenario 2). Although many retrospective cohort studies and nonrandomized trials have implicated efficacy of this approach the evidence from randomized controlled studies has not been summarized. In the current review we report the results of a systematic review and meta-analysis of randomized controlled trials.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ensayos Clínicos Controlados Aleatorios como Asunto / Trasplante de Hígado / Inhibidores de la Calcineurina / Inmunosupresores / Ácido Micofenólico Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2012 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ensayos Clínicos Controlados Aleatorios como Asunto / Trasplante de Hígado / Inhibidores de la Calcineurina / Inmunosupresores / Ácido Micofenólico Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2012 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos