What have we learned about primary liver transplantation under tacrolimus immunosuppression ? Long-term follow-up of the first 1000 patients. Discussion.
Annual Scientific Session of the American Surgical Association. San Diego, CA, USA, 1999/04.
Objective To summarize the long-term efficacy and safety of tacrolimus in orthotopic liver transplant (OLT) recipients, as well as to examine the factors that influence long-term morbidity and mortality rates.
Background Tacrolimus (FK506, Prograf) was introduced as primary immunosuppression for primary liver transplantation in 1989 ; many subsquent trials have verified the association of tacrolimus with decreased rates of acute rejection and steroid-resistant rejection after OLT.
Cumulative experience with tacrolimus has also defined its short-and intermediate-term toxicity.
Methods One thousand consecutive patients undergoing primary OLT at a single center from August 1989 to December 1992, under tacrolimus immunosuppression, were followed until January 1999.
Patients were categorized by age.
Mean follow-up was 93.4 ± 11 months after OLT.
Patient survival, graft survival (with corresponding causes of death and retransplantation), and rejection rates (and corresponding doses of immunosuppression) were examined as efficacy parameters.
Hypertension, renal function, incidence of malignancies, incidence of diabetes, and other toxicities were examined as safety parameters.
Results Actual 6-year overall patient survival rate was 68.1% and graft survival rate was 62.5%, with significant differences in the patterns of survival among the different age groups. (...)
Mots-clés Pascal : Transplantation, Primaire, Foie, Tacrolimus, Etude longitudinale, Long terme, Efficacité traitement, Effet secondaire, Evaluation, Survie, Homme, Chirurgie, Appareil digestif pathologie, Foie pathologie, Immunodépresseur
Mots-clés Pascal anglais : Transplantation, Primary, Liver, Tacrolimus, Follow up study, Long term, Treatment efficiency, Secondary effect, Evaluation, Survival, Human, Surgery, Digestive diseases, Hepatic disease, Immunosuppressive agent
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0517096
Code Inist : 002B02R03. Création : 18/05/2000.