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Everolimus-based immunosuppression in liver transplant recipients: a single-centre experience.

TitleEverolimus-based immunosuppression in liver transplant recipients: a single-centre experience.
Publication TypeJournal Article
Year of Publication2014
AuthorsCholongitas, Ε., Goulis I., Theocharidou E., Antoniadis N., Fouzas I., Giakoustidis D., Imvrios G., Giouleme O., Papanikolaou V., Akriviadis E., & Vasiliadis T.
JournalHepatol Int
Volume8
Issue1
Pagination137-45
Date Published2014 Jan
ISSN1936-0541
Abstract

PURPOSE: Everolimus, a mammalian target of rapamycin inhibitor, has been shown to reduce growth factor-mediated cell proliferation, but data regarding its effectiveness and impact on renal function and recurrence of hepatocellular carcinoma (HCC) in liver transplant (LT) recipients are limited.METHODS: We evaluated LT recipients with a calcineurin inhibitor (CNI)-based immunosuppression regimen in whom everolimus treatment was initiated. The changes in laboratory data, including glomerular filtration rate (GFR), compared to the baseline (i.e. the day of everolimus conversion), were assessed.RESULTS: Totally, 44 consecutive patients (32 men, age 55 ± 7 years) were commenced on everolimus [indications: renal dysfunction post-LT (16 patients, group 1); prevention of HCC recurrence (21 patients) or others (7 patients), group 2] at 6 months (range 1-206) post-LT. After 48 (range 12-76) months, all patients were alive without any rejection episodes. Compared to group 2 patients, group 1 patients had significantly greater improvement in renal function (DGFR: 12 ± 5 vs. -0.4 ± 0.2 ml/min, p = 0.02). GFR at baseline (OR 0.08, p = 0.002) and the combination of everolimus + MMF (OR 0.14, p = 0.024) were the factors independently associated with improvement in renal function. Finally, HCC recurrence was observed less frequently in the everolimus group of patients (n = 21) compared to the CNI-historical control group (n = 22) with HCC before LT [0/21 (0 %) vs. 4/22 (18.5 %), log rank p = 0.055), although the two groups of recipients had similar baseline characteristics and follow-up.CONCLUSIONS: Everolimus is effective and is associated with low rates of HCC recurrence and improvement of renal function in LT recipients.

DOI10.1007/s12072-013-9492-6
Alternate JournalHepatol Int
PubMed ID26202415

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