We investigated retrospectively the impact of conversion from calcineurin inhibitors (CNI) to everolimus (EVL) monotherapy on renal function (RF) in liver transplant (LT) recipients. Between January 2006 and July 2007, 70 recipients (51 M, 19 F; mean age 55.9±11 years) from a deceased donor were enrolled into a program of conversion to EVL monotherapy at a mean interval of 45±35.9 months from transplantation (range 7-192). Indications for conversion were deteriorating RF in 63 (90%). Effi cacy failure was defi ned as persistence of CNI, EVL discontinuation, death, graft loss, loss to follow-up and need for dialysis at 12 months. Twelve months after switching, 53 patients (75.7%) were on EVL monotherapy and the mean change of creatinine clearance (CrCl) from baseline (-day 1 before EVL introduction) to endpoint (12 months) was 5.8±13.1 mL/min. On univariate and multivariate analyses the clinical variable correlated with the greatest probability of improvement was the baseline CrCl (p<0.0001). Conversion from CNI to EVL monotherapy is successful in 75.7% of cases and the improvement in RF is correlated with baseline CrCl. These data support pre-emptive minimization of CNI in the post-transplant course in order to delay the decline in renal function.
The impact of everolimus on renal function in maintenance liver transplantation
De Simone P;Campani D;Filipponi F
2009-01-01
Abstract
We investigated retrospectively the impact of conversion from calcineurin inhibitors (CNI) to everolimus (EVL) monotherapy on renal function (RF) in liver transplant (LT) recipients. Between January 2006 and July 2007, 70 recipients (51 M, 19 F; mean age 55.9±11 years) from a deceased donor were enrolled into a program of conversion to EVL monotherapy at a mean interval of 45±35.9 months from transplantation (range 7-192). Indications for conversion were deteriorating RF in 63 (90%). Effi cacy failure was defi ned as persistence of CNI, EVL discontinuation, death, graft loss, loss to follow-up and need for dialysis at 12 months. Twelve months after switching, 53 patients (75.7%) were on EVL monotherapy and the mean change of creatinine clearance (CrCl) from baseline (-day 1 before EVL introduction) to endpoint (12 months) was 5.8±13.1 mL/min. On univariate and multivariate analyses the clinical variable correlated with the greatest probability of improvement was the baseline CrCl (p<0.0001). Conversion from CNI to EVL monotherapy is successful in 75.7% of cases and the improvement in RF is correlated with baseline CrCl. These data support pre-emptive minimization of CNI in the post-transplant course in order to delay the decline in renal function.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
