Safety and effectiveness of mycophenolate mofetil associated with tacrolimus for liver transplantation immunosuppression: a systematic review and meta-analysis of randomized controlled trials

Tustumi, Francisco; Neto, Antônio Afonso de Miranda; Júnior, Sérgio Silveira; Fernandes, Felipe Alexandre; Silva, Miller Barreto de Brito e; Ernani, Lucas; Nacif, Lucas Souto; Coelho, Fabrício Ferreira; Andraus, Wellington; Bernardo, Wanderley Marques; Herman, Paulo; Carneiro-D’Albuquerque, Luiz Augusto

doi:10.6061/clinics/2021/e2597

Cited by 5 publications

(1 citation statement)

References 19 publications

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“…Tacrolimus binds to immunophilin receptors (FK 506-binding proteins {FKBPs}), blocks calcineurin phosphatase activity, and thus inhibits the transcription of genes involved in IL-2 synthesis [ 17 ]. Its effect on COVID-19 is still unknown; however, some data suggest that calcineurin inhibitors have a direct antiviral effect [ 18 ]. All our patients were on tacrolimus therapy when admitted for COVID-19 pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 Infection on Liver Transplant Recipients: Does It Make Any Difference?

Punga¹,

Isac²,

Paraipan³

et al. 2022

Cureus

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The first case of coronavirus disease 2019 (COVID-19) was diagnosed in December 2019 in Wuhan, China. Since then, this novel infectious disease, caused by the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), has grown into a pandemic with over 330 million infected individuals worldwide, many of them with innate or acquired immunosuppression.Liver transplantation (LT) is offered as a curative therapy for end-stage liver disease as well as for acute liver failure cases. Advances in immunosuppressive therapy decreased the rates of acute and chronic graft rejection, significantly improving the quality of life.Liver transplant recipients are considered at particularly high risk for developing critical COVID-19 infection because of their chronic immunosuppressed state. Available data are heterogeneous, and the mortality rate is variably reported in the literature. There is controversy regarding whether their immunosuppressive status is a risk or a protective factor for developing severe respiratory disease. Moreover, the mechanism of action is still unclear.We report the clinical outcome of three liver transplant recipients who had COVID-19 pneumonia at different moments following liver transplantation. All patients received a standard immunosuppression regimen and specific antiviral therapy, requiring no invasive mechanical ventilation. They were discharged from the hospital with no long-term COVID-19 complications.

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Section: Discussionmentioning

confidence: 99%