Prednisone withdrawal 14 days after liver transplantation with mycophenolate a prospective trial of cyclosporine and tacrolimus

摘要: Background The long-term complications of immunosuppressive therapy such as diabetes, hypercholesterolemia, and hypertension are a major source morbidity in liver transplant recipients. In this prospective, randomized, open-label study we completely withdrew prednisone (PRED) 14 days after transplantation an effort to decrease these metabolic complications. Patients were maintained on mycophenolate mofetil (MMF) combination with either cyclosporine (CsA; Neoral formulation) or tacrolimus (TAC). Thus, also able compare CsA TAC patients not receiving PRED respect efficacy, toxicity, effect posttransplant Methods. A total 71 randomized receive TAC-MMF (n=35) CsA-MMF (n=36) analyzed for patient graft survival. Fifty-eight continued the protocol at least 6 months incidence acute rejection prevalence hypertension, hypercholesterolemia. Results. 6-month survival rates 94.4% 88.6% TAC-MMF. Corresponding 88.7% 85.7% no immunologic losses group. biopsy-proven was 46% 42.3% Six converted from (four recurrent rejection) seven neurotoxicity). Only one (in group) developed newonset diabetes. contrast, four eight group who diabetic before became nondiabetic first 3 transplant. mean serum cholesterol level significantly lower than (145.2±41.8 mg/dl 190.3±62.2, respectively; P<0.001) (12% vs. 30.3% group, P<0.01). Both groups had compared historical (n=100) (10 mg/day months). Conclusions. MMF allows withdrawal moderate rate losses. Early decreases but have levels CsA-treated patients.