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Immunosuppression in liver transplantation: beyond calcineurin inhibitors.

Authors
  • Fung, John
  • Kelly, Dympna
  • Kadry, Zakiyah
  • Patel-Tom, Kusum
  • Eghtesad, Bijan
Type
Published Article
Journal
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Publication Date
Mar 01, 2005
Volume
11
Issue
3
Pages
267–280
Identifiers
PMID: 15719409
Source
Medline
License
Unknown

Abstract

Although calcineurin inhibitors (CNIs) remain the mainstay of immunosuppression in liver transplantation (LTX), their long-term toxicity significantly contributes to morbidity and mortality. The elucidation of mechanisms of alloimmunity and leukocyte migration have provided novel targets for immunosuppression development. The toxicities of these agents differ from that of the CNI and act additively or synergistically. CNI avoidance protocols in LTX have not been achieved routinely; however, pilot trials have begun to delineate the limitations and promises of such approaches. CNI-sparing protocols appear to be much more promising in balancing the early need for minimizing rejection while tapering doses and minimizing long-term toxicity.

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