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Medical Science Monitor Basic Research

AmJCaseRep
MedSciTechnol

eISSN: 2329-0358

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Early Initiation of Everolimus After Liver Transplantation: A Single-Center Experience

Uta Herden, Antonio Galante, Lutz Fischer, Sven Pischke, Jun Li, Eike Achilles, Martina Koch, Bjoern Nashan, Martina Sterneck

(Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany)

Ann Transplant 2016; 21:77-85

DOI: 10.12659/AOT.895800


BACKGROUND: Evidence relating to early everolimus use after liver transplantation remains limited.
MATERIAL AND METHODS: Ninety-one adult patients undergoing liver transplantation at our center during 2007–2012 in whom everolimus therapy was initiated <3 months post-transplant were analyzed retrospectively. Everolimus was started on days 1–5 in 50 patients (group 1) and after day 5 in 41 patients (group 2). Most patients continued to receive low-dose cyclosporine (59.3%, target 50–80 ng/ml) or low-dose tacrolimus (25.3%; target 3–5 ng/ml). Mean follow-up was 4.6 years.
RESULTS: One-, three- and five-year patient survival rates were 80.5%, 74.2%, and 70.5%, respectively, and did not differ between groups 1 and 2. Six patients (6.6%) developed biopsy-proven acute rejection after a median of 47 days (range 27–356 days). Everolimus was discontinued due to adverse events in 21 patients (23.1%). Incisional hernia repair occurred in 14.0% and 9.4% of patients in group 1 and 2, respectively. Renal function remained stable during follow-up, despite poor baseline function.
CONCLUSIONS: Everolimus with very low-dose calcineurin inhibitor given immediately after liver transplantation appears safe and effective, achieving a low rejection rate with well-preserved renal function.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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