Herzer, Kerstin and Strassburg, Christian P. and Braun, Felix and Engelmann, Cornelius and Guba, Markus and Lehner, Frank and Nadalin, Silvio and Pascher, Andreas and Scherer, Marcus N. and Schnitzbauer, Andreas A. and Zimmermann, Tim and Nashan, Bjoern and Sterneck, Martina (2016) Selection and use of immunosuppressive therapies after liver transplantation: current German practice. CLINICAL TRANSPLANTATION, 30 (5). pp. 487-501. ISSN 0902-0063, 1399-0012
Full text not available from this repository. (Request a copy)Abstract
In recent years, immunosuppression (IS) after liver transplantation (LT) has become increasingly diversified as the choice of agents has expanded and clinicians seek to optimize the balance of immunosuppressive potency with the risk of adverse events in individual patients. Calcineurin inhibitors (CNIs) are the primary agents used for patients undergoing liver transplantation. Other therapeutic agents like interleukin-2 receptor antagonists are not universally administered, but can be considered for the delay or reduction in CNI exposure. An early addition of mycophenolate mofetil (MMF) or the mTOR inhibitor everolimus also allows for the reduction in the CNI dose. To reduce the risk of malignancy, in particular of skin tumors, as well as to prevent the deterioration of renal function, everolimus-based therapy may be advantageous. Apart from patients with autoimmune hepatitis, steroids are withdrawn within 3-6 months after transplantation. Overall, immunosuppression can only be standardized in a limited proportion of patients due to specific clinical requirements and risk factors. Future studies should attempt to refine accurate individualization of the immunosuppressive regimen in specific difficult-to-treat patient subpopulations.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RANDOMIZED CONTROLLED-TRIAL; REDUCED-DOSE TACROLIMUS; CORTICOSTEROID-FREE IMMUNOSUPPRESSION; MYCOPHENOLATE-MOFETIL MONOTHERAPY; SIROLIMUS-BASED IMMUNOSUPPRESSION; PROLONGED-RELEASE TACROLIMUS; PLACEBO-CONTROLLED TRIAL; SOLID-ORGAN TRANSPLANT; CHRONIC-RENAL-FAILURE; CALCINEURIN-INHIBITORS; antiproliferative drugs; calcineurin inhibitors; everolimus; immunosuppression; induction; liver transplantation; mycophenolate mofetil; steroids |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentren des Universitätsklinikums Regensburg > Transplantationszentrum |
| Depositing User: | Petra Gürster |
| Date Deposited: | 01 Sep 2020 08:40 |
| Last Modified: | 01 Sep 2020 08:40 |
| URI: | https://pred.uni-regensburg.de/id/eprint/3002 |
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