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 28 May 2018

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News

Combination therapy improves liver transplant outcomes

Mycophenolate mofetil added to tacrolimus-based immunosuppression at discharge is associated with improved outcomes after liver transplantation with and without Hepatitis C, finds July's issue of Liver Transplantation.

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Dr Wiesner and colleagues of Minnesota evaluated the impact of mycophenolate mofetil on long-term outcomes of tacrolimus and corticosteroids.

The investigators analyzed data reported to the Scientific Registry of Transplant Recipients between 1995 and 2001.

The investigative team considered data for 11,670 adult patients, of which 3463 had Hepatitis C, who underwent primary, single-organ, liver transplantation.

Combinatinon treatment had 81% patient survival vs 77% for tacrolimus alone
Liver Transplantation

The team included 4466 patients with mycophenolate mofetil of which 1322 had Hepatitis C.

The team also included 7204 patients without mycophenolate mofetil of which 2140 had Hepatitis C.

The included patients were discharged from the hospital on tacrolimus-based immunosuppression.

The investigators found that recipients treated at discharge with mycophenolate mofetil, tacrolimus, and corticosteroids had and 81% patient survival rate.

Patients survival was 77% for those treated with tacrolimus and corticosteroids alone.

The team observed that graft survival was 76% for the combination group versus 73% for tacrolimus and corticosteroids alone.

The investigators noted acute rejection rates of 29% for the mycophenolate mofetil recipients versus 33% treated with tacrolimus and corticosteroids alone.

A trend toward lower rates of death from infection at 4 years was and observed 6% for mycophenolate mofetil versus 7% for tacrolimus and corticosteroids.

The team reported however, that this result did not reach statistical significance.

In multiple regression analyses, mycophenolate mofetil triple therapy at discharge was associated with a reduced risk of death.

In addition, the team found that triple therapy was associated with reduced graft loss, acute rejection, and death from infectious complications.

The investigators found similar outcomes for the cohort with Hepatitis C.

Dr Wiesner's team concludes, “The addition of mycophenolate mofetil at discharge to tacrolimus-based immunosuppression is associated with improved long-term outcomes after liver transplantation in patients with and without Hepatitis C.”

Liver Transplant 2005: 11(7): 750-9
28 June 2005

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