BACKGROUND: Due to the nephrotoxicity of calcineurin inhibitors (CNIs) mycophenolate mofetil (MMF) has become a promising immunosuppressive alternative in recent years. In several studies an improvement of renal function could be reached by introduction of MMF and withdrawal of CNIs but there is few known about the long-term effects of MMF on liver-, kidney- and bone marrow function. MATERIAL AND METHODS: We therefore retrospectively reviewed 123 adult liver transplant patients who were successfully converted to MMF monotherapy without any acute rejection within the first three months of MMF monotherapy. RESULTS: Serum levels of liver enzymes as well as white blood cells did not show any significant difference between the time of conversion and after 1 year but a significant reduction in serum creatinine could be evaluated (1.47 mg/dl vs. 1.54 mg/dl). In 59 patients liver biopsies were performed before and after introduction of MMF monotherapy. None displayed signs of chronic rejection during MMF monotherapy but there was a slight increase of the fat content of the liver (16.1% vs. 9.8%). CONCLUSIONS: In conclusion after successful conversion to MMF monotherapy this regime is safe and effective and the long-term effects of MMF monotherapy on the liver tissue are minor. Furthermore renal function can be improved without considerable effects on the bone marrow.
BACKGROUND: Due to the nephrotoxicity of calcineurin inhibitors (CNIs) mycophenolate mofetil (MMF) has become a promising immunosuppressive alternative in recent years. In several studies an improvement of renal function could be reached by introduction of MMF and withdrawal of CNIs but there is few known about the long-term effects of MMF on liver-, kidney- and bone marrow function. MATERIAL AND METHODS: We therefore retrospectively reviewed 123 adult liver transplant patients who were successfully converted to MMF monotherapy without any acute rejection within the first three months of MMF monotherapy. RESULTS: Serum levels of liver enzymes as well as white blood cells did not show any significant difference between the time of conversion and after 1 year but a significant reduction in serum creatinine could be evaluated (1.47 mg/dl vs. 1.54 mg/dl). In 59 patients liver biopsies were performed before and after introduction of MMF monotherapy. None displayed signs of chronic rejection during MMF monotherapy but there was a slight increase of the fat content of the liver (16.1% vs. 9.8%). CONCLUSIONS: In conclusion after successful conversion to MMF monotherapy this regime is safe and effective and the long-term effects of MMF monotherapy on the liver tissue are minor. Furthermore renal function can be improved without considerable effects on the bone marrow.
Authors: C Dopazo; I Bilbao; L L Castells; G Sapisochin; C Moreiras; I Campos-Varela; J Echeverri; M Caralt; J L Lázaro; R Charco Journal: Hepatol Int Date: 2014-09-18 Impact factor: 6.047