Treatment of renal dysfunction after orthotopic liver transplantation: Options and outcomes

被引:12
作者
Gonwa, TA [1 ]
机构
[1] Mayo Clin Jacksonville, Jacksonville, FL 32224 USA
关键词
D O I
10.1002/lt.500090722
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Chronic nephrotoxicity is one of the most serious side-effects of calcineurin inhibitor treatment and a factor in mortality and morbidity after liver transplantation. In our transplant centre,. among. patients who underwent a liver transplantation between January, 1989 and December 2066, 14 liver graft recipients (6.86%) developed de novo severe. renal dysfunction as defined by a serum creatinine concentration above 200 micromol/L. Renal biopsy was performed in nine cases and evidenced histological lesions compatible with. chronic. nephrotoxicity related to calcineurin inhibitor treatment. For nine patients, we report the results of a prospective non randomized study consisting of. cyclosporine or tacrolimus withdrawal associated with administration of mycophenolate mofetil or azathioprine. Despite this therapeutic modification, we did not observe a significant renal function improvement but on the other hand, there was no graft rejection.
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收藏
页码:778 / 779
页数:2
相关论文
共 8 条
[1]   Chronic renal dysfunction late after liver transplantation [J].
Cohen, AJ ;
Stegall, MD ;
Rosen, CB ;
Wiesner, RH ;
Leung, N ;
Kremers, WK ;
Zein, NN .
LIVER TRANSPLANTATION, 2002, 8 (10) :916-921
[2]   Chronic renal failure following liver transplantation - A retrospective analysis [J].
Fisher, NC ;
Nightingale, PG ;
Gunson, BK ;
Lipkin, GW ;
Neuberger, JM .
TRANSPLANTATION, 1998, 66 (01) :59-66
[3]   End-stage renal disease (ESRD) after orthotopic liver transplantation (OLTX) using calcineurin-based immunotherapy - Risk of development and treatment [J].
Gonwa, TA ;
Mai, ML ;
Melton, LB ;
Hays, SR ;
Goldstein, RM ;
Levy, MF ;
Klintmalm, GB .
TRANSPLANTATION, 2001, 72 (12) :1934-1939
[4]   Sirolimus monotherapy in nephrotoxicity due to calcineurin inhibitors in liver transplant recipients [J].
Nair, S ;
Eason, J ;
Loss, G .
LIVER TRANSPLANTATION, 2003, 9 (02) :126-129
[5]   Long-term mycophenolate mofetil monotherapy in combination with calcineurin inhibitors for chronic renal dysfunction after liver transplantation [J].
Raimondo, ML ;
Dagher, L ;
Papatheodoridis, GV ;
Rolando, N ;
Patch, DW ;
Davidson, BR ;
Rolles, K ;
Burroughs, AK .
TRANSPLANTATION, 2003, 75 (02) :186-190
[6]  
SANDBORN WJ, 1994, HEPATOLOGY, V19, P925
[7]   Replacement of calcineurin inhibitors with mycophenolate mofetil in liver-transplant patients with renal dysfunction:: a randomised controlled study [J].
Schlitt, HJ ;
Barkmann, A ;
Böker, KHW ;
Schmidt, HHJ ;
Emmanouilidis, N ;
Rosenau, J ;
Bahr, MJ ;
Tusch, G ;
Manns, MP ;
Nashan, B ;
Klempnauer, J .
LANCET, 2001, 357 (9256) :587-591
[8]   Mycophenolate mofetil monotherapy in liver transplantation [J].
Stewart, SF ;
Hudson, M ;
Talbot, D ;
Manas, D ;
Day, CP .
LANCET, 2001, 357 (9256) :609-610