Effects of mycophenolate mofetil introduction in liver transplant patients: results from an observational,non‐interventional,multicenter study (LOBSTER) |
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| Authors: | Hans J Schlitt Sven Jonas Tom M Ganten Gerrit Grannas Christian Moench Falk Rauchfuss Aiman Obed Giuseppe Tisone Antonio D Pinna Giorgio E Gerunda Susanne Beckebaum |
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| Institution: | 1. Department of Surgery, University of Regensburg, , Regensburg, Germany;2. Department of Abdominal and Transplantation Surgery, University Medical Center Leipzig, , Leipzig, Germany;3. Department of Gastroenterology, Internal Medicine, University of Heidelberg, , Heidelberg, Germany;4. Department of General, Visceral and Transplantation Surgery, Hannover Medical School, , Hannover, Germany;5. Hospital for General and Visceral Surgery, Clinical Center of the Johann Wolfgang Goethe University, , Frankfurt, Germany;6. Department of General, Visceral and Vascular Surgery, University Hospital Jena, , Jena, Germany;7. Transplant Surgery, Department of Surgery, University Medical Center G?ttingen, , G?ttingen, Germany;8. Surgery and Transplantation, University Hospital Policlinico di Tor Vergata, , Rome, Italy;9. Department of General Surgery and Transplantation, S. Orsola Hospital, University of Bologna, , Bologna, Italy;10. Liver and Multivisceral Transplantation Unit, University of Modena and Reggio Emilia, , Modena, Italy;11. Department of General, Visceral and Transplantation Surgery, University Hospital Essen, , Essen, Germany |
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| Abstract: | The benefits of calcineurin inhibitor (CNI)‐sparing regimens on renal function following liver transplantation (LT) have been demonstrated in clinical studies. This observational study assessed the real‐life effects of mycophenolate mofetil (MMF) introduction in LT patients. Four hundred and ninety‐seven patients in whom MMF was introduced according to local standards or clinical considerations were entered. Patients were grouped by time between transplantation and start of MMF (start of study): Group A (n = 263): ≤6 d; Group B (n = 64): >6 d to ≤1 month; Group C (n = 74): >1 month to ≤1 yr; and Group D (n = 96): >1 yr. CNI sparing occurred in all groups, particularly in Groups C and D. Mean MMF doses at 12 months were 1202.7, 1363.5, 1504.7, and 1578.1 mg/d, respectively, in Groups A–D. At introduction of MMF, median glomerular filtration rate was 73.3, 81.7, 62.7, and 53.7 mL/min/1.73 m2 in Groups A–D. At 12 months, this decreased to 66 mL/min/1.73 m2 in Groups A and B, remained stable in Group C, and increased in Group D (64.8 mL/min/1.73 m2). Serious adverse drug reactions were lowest in Group D. In conclusion, MMF with a subsequent decrease in CNI was well tolerated and improved renal function even years after transplantation. A more forceful MMF dosing strategy with greater CNI sparing may further improve renal function. |
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| Keywords: | calcineurin inhibitor liver transplantation mycophenolate mofetil renal function |
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