Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients |
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| Authors: | Valentín Cuervas‐Mons J. Ignacio Herrero Miguel A. Gomez Ignacio González‐Pinto Trinidad Serrano Manuel de la Mata Joan Fabregat Mikel Gastaca Itxarone Bilbao Evaristo Varo Gloria Sánchez‐Antolín Juan Rodrigo María Dolores Espinosa |
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| Affiliation: | 1. Department of Internal Medicine, Liver Transplant Unit, Hospital Puerta de Hierro, Madrid, Spain;2. Liver Unit, Clínica Universitaria de Navarra, Pamplona, Spain;3. CIBERehd (Centro de Investigación Biomédica en Red), Instituto de Salud Carlos III (ISCIII), Madrid, Spain;4. Hepatobiliopancreatic Surgery and Transplantation Unit, Hospital Virgen del Rocío, Sevilla, Spain;5. Liver Transplantation Unit, Hospital Universitario Central de Asturias, Oviedo, Spain;6. Hospital Lozano Blesa, Zaragoza, Spain;7. Clinical Management Unit of Digestive System, Hepatology Section, Hospital Universitario Reina Sofía, Córdoba, Spain;8. Hepatobiliopancreatic Surgery and Liver Transplantation Unit, Hospital Universitari de Bellvitge, Barcelona, Spain;9. Hospital Cruces, Bilbao, Spain;10. Service of Hepatobiliopancreatic Surgery and Liver Transplantation, Hospital Universitario Vall d'Hebrón, Barcelona, Spain;11. Abdominal Transplantation Unit, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain;12. Liver Transplant Unit, Hospital Universitario Río Hortega, Valladolid, Spain;13. Hepatology and Liver Transplantation Unit, Hospital Regional Universitario de Málaga, Málaga, Spain;14. Hepatology and Liver Transplantation Unit, Service of Digestive System, Hospitales Universitarios de Granada, Granada, Spain |
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| Abstract: | The aim of this study was to evaluate the impact of a steroid‐free regimen with tacrolimus and mycophenolate mofetil (modified therapy) vs. a standard regimen of tacrolimus and steroids on the cardiovascular risk score of liver transplant recipients. Patients who received a liver transplant were randomized to a modified therapy (n = 58) or a standard regimen (n = 59). Both groups were balanced at baseline, except for a higher prevalence of diabetes mellitus (DM) (p < 0.01) and a higher serum creatinine concentration (p < 0.05) in the modified therapy group. After 12 months, the prevalence of new‐onset DM, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, and changes in cardiovascular risk factors was similar in both groups. The increase in serum creatinine (mg/dL) compared to baseline at one yr post‐transplantation was numerically lower in the modified therapy group (0.22 ± 0.42) than in the standard regimen group (0.41 ± 0.67) (p = 0.068). Although estimated cardiovascular risk score did not vary significantly compared to baseline in either group, there was a slight reduction in the modified regimen (?0.27 ± 2.87) vs. a mild increase (0.17 ± 2.94) in the standard regimen (p = 0.566). In conclusion, a steroid‐free regimen with tacrolimus and mycophenolate mofetil was associated with a trend toward better preservation of kidney function and reduction of cardiovascular risk score. |
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| Keywords: | cardiovascular risk factors immunosuppression liver transplantation mycophenolate mofetil steroids tacrolimus |
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