Mycophenolate mofetil monotherapy in liver transplant recipients

Kriss, Michael; Sotil, Eva U.; Abecassis, Michael; Welti, Mary; Levitsky, Josh

doi:10.1111/j.1399-0012.2011.01512.x

Cited by 7 publications

(3 citation statements)

References 39 publications

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“…Mycophenolic acid (MPA) was selected for its ability to inhibit de novo synthesis of purine and was consequently developed into the morpholinoethyl ester of MPA under the name MMF 68 . MMF has high bioavailability and is hydrolyzed to MPA after oral administration to prevent T- and B-cell proliferation by inhibiting inosine monophosphate dehydrogenase, which controls de novo biosynthesis of purine 68 , 69 .…”

Section: Resultsmentioning

confidence: 99%

“…In renal transplant studies, MMF showed effectiveness in acute rejection rescue therapy, and combination administration of cyclosporine and MMF significantly reduced acute allograft rejection compared to placebo or azathioprine, another antagonist of purine metabolism 68 . In liver transplant studies, conversion from CNI to MMF monotherapy led to significant improvements in the serum creatinine level and calculated GFR 69 . Based on the most recent retrospective study of MMF monotherapy enrolling 94 liver transplant patients, the regimen was feasible without a high risk of acute rejection (4.2%, 4/94), and the estimated GFR was significantly increased by 6.3% for up to 5 years 71 .…”

Section: Resultsmentioning

confidence: 99%

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Review of two immunosuppressants: tacrolimus and cyclosporine

Lee,

Myoung,

Kim

2023

JKAOMS

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Immunosuppressants are vital in organ transplantation including facial transplantation (FT) but are associated with persistent side effects. This review article was prepared to compare the two most used immunosuppressants, cyclosporine and tacrolimus, in terms of mechanism of action, efficacy, and safety and to assess recent trials to mitigate their side effects. PubMed and Google Scholar queries were conducted using combinations of the following search terms: "transplantation immunosuppressant," "cyclosporine," "tacrolimus," "calcineurin inhibitor (CNI)," "efficacy," "safety," "induction therapy," "maintenance therapy," and "conversion therapy." Both immunosuppressants inhibit calcineurin and effectively down-regulate cytokines. Tacrolimus may be more advantageous since it lowers the likelihood of acute rejection, has the ability to reverse allograft rejection following cyclosporine treatment, and has the potential to reinnervate nerves. Meanwhile, graft survival rates seem to be comparable for the CNIs. To avoid nephrotoxicity, various immunosuppressants other than CNIs have been studied. Despite averting nephrotoxicity, these medications show increases in acute rejection or other types of adverse effects compared to CNIs. FT has been a topic of interest for oral and maxillofacial surgeons, and the postoperative usage of immunosuppressants is crucial for the long-term prognosis of FT. As contemporary transplantation regimens incorporate novel medications along with CNIs, further research is required.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Review of two immunosuppressants: tacrolimus and cyclosporine

Lee,

Myoung,

Kim

2023

JKAOMS

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show abstract

“…Most patients are off corticosteroids by 3 months after LT. 109 Patients on dual therapy and have stable graft function may be switched to TAC monotherapy any time after 3 months. 59,110,111 TAC minimization with EVR or MMF is done in patients with renal dysfunction. Complete withdrawal of TAC with EVR or MMF monotherapy increases the risk of rejection, and it is not recommended in the first year after transplantation.…”

Section: Immunosuppression Minimization Protocolsmentioning

confidence: 99%