000061307 001__ 61307
000061307 005__ 20240111111737.0
000061307 0247_ $$2doi$$a10.12659/AOT.902523
000061307 0248_ $$2sideral$$a98689
000061307 037__ $$aART-2017-98689
000061307 041__ $$aeng
000061307 100__ $$aAguiar, D.
000061307 245__ $$aReal-World Multicenter Experience of Immunosuppression Minimization Among 661 Liver Transplant Recipients.
000061307 260__ $$c2017
000061307 5060_ $$aAccess copy available to the general public$$fUnrestricted
000061307 5203_ $$aBACKGROUND Long-term morbidity and mortality in liver transplant recipients is frequently secondary to immunosuppression toxicity. However, data are scarce regarding immunosuppression minimization in clinical practice. MATERIAL AND METHODS In this cross-sectional, multicenter study, we reviewed the indications of immunosuppression minimization (defined as tacrolimus levels below 5 ng/mL or cyclosporine levels below 50 ng/mL) among 661 liver transplant recipients, as well as associated factors and the effect on renal function. RESULTS Fifty-three percent of the patients received minimized immunosuppression. The median time from transplantation to minimization was 32 months. The most frequent indications were renal insufficiency (49%), cardiovascular risk (19%), de novo malignancy (8%), and cardiovascular disease (7%). The factors associated with minimization were older age at transplantation, longer post-transplant follow-up, pre-transplant diabetes mellitus and renal dysfunction, and the hospital where the patients were being followed. The patients who were minimized because of renal insufficiency had a significant improvement in renal function (decrease of the median serum creatinine level, from 1.50 to 1.34 mg/dL; P=0.004). Renal function significantly improved in patients minimized for other indications, too. In the long term, glomerular filtration rate significantly decreased in non-minimized patients and remained stable in minimized patients. CONCLUSIONS Immunosuppression minimization is frequently undertaken in long-term liver transplant recipients, mainly for renal insufficiency. Substantial variability exists regarding the use of IS minimization among centers.
000061307 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000061307 590__ $$a1.054$$b2017
000061307 591__ $$aTRANSPLANTATION$$b22 / 25 = 0.88$$c2017$$dQ4$$eT3
000061307 591__ $$aSURGERY$$b156 / 200 = 0.78$$c2017$$dQ4$$eT3
000061307 592__ $$a0.456$$b2017
000061307 593__ $$aTransplantation$$c2017$$dQ3
000061307 593__ $$aMedicine (miscellaneous)$$c2017$$dQ3
000061307 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000061307 700__ $$aMartínez-Urbistondo, D.
000061307 700__ $$aBaroja-Mazo, A.
000061307 700__ $$ade la Mata, M.
000061307 700__ $$aRodríguez-Perálvarez, M.
000061307 700__ $$aRubín, A.
000061307 700__ $$aPuchades, L.
000061307 700__ $$0(orcid)0000-0002-7119-2244$$aSerrano, T.$$uUniversidad de Zaragoza
000061307 700__ $$aMontero, J.
000061307 700__ $$aCuadrado, A.
000061307 700__ $$aCasafont, F.
000061307 700__ $$aSalcedo, M.
000061307 700__ $$aRincón, D.
000061307 700__ $$aPons, J.A.
000061307 700__ $$aHerrero, J.I.
000061307 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000061307 773__ $$g22 (2017), 265 - 275$$pAnnals of Transplantation$$tAnnals of Transplantation$$x1425-9524
000061307 8564_ $$s493093$$uhttps://zaguan.unizar.es/record/61307/files/texto_completo.pdf$$yVersión publicada
000061307 8564_ $$s83513$$uhttps://zaguan.unizar.es/record/61307/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000061307 909CO $$ooai:zaguan.unizar.es:61307$$particulos$$pdriver
000061307 951__ $$a2024-01-11-10:59:26
000061307 980__ $$aARTICLE