Update on liver transplantation using cyclosporine

摘要: After the introduction of cyclosporine into liver transplantation in 1983, 1-year patient survival more than doubled. Later, with improved microemulsified formulation (Neoral) stable pharmacokinetics were achieved. Today, C2 monitoring blood levels allows a accurate estimation area under concentration-versus-time curve as single best indicator exposure. As consequence, better control side effects well desired results have been further improved. The mycophenolate mofetil and basiliximab/daclizumab combination therapy has provided new options for prevention allograft rejection. safety profile individual immunosuppressive regimens comes focus since acute rejection may be controlled successfully competing strategies. is shifting toward greatly long-term results, late posttransplant mortality functioning graft major concern. Prevention complications associated highly effective immunosuppressants—posttransplant lymphoproliferative disease, cytomegalovirus infection, diabetes, hypertension, hyperlipidemia—gains importance. Technical advances living-related cadaveric split-liver lead to increasing use segmental need consider immunosuppression on regeneration metabolism. individualized orchestration taking account underlying disease other predispositions remains future challenge.