Effects of progressive introduction of calcineurin inhibitors on the renal function of a cohort of liver transplant recipients

Abstract

Background: acute renal disease (ARD) occurs in liver transplantation with an incidence ranging from 12 to 64%, with an associated hospital mortality of 40 to 67%.This study used the RIFLE criteria to analyze the effect of an immunosuppressive regime including calcineurin inhibitors (CNi) in the development of ARD in patients with liver transplantation. It also assesses the protocol and progressive late introduction of CNi as a strategy to reduce the incidence of posttransplant ARD

Methods: cohort analytic study of 163 patients with liver transplantation

Results: 163 patients met the study inclusion criteria with an average age of 51 (46-56) years. Of these patients, only 11 (6.74%) had ARD transplantation. Cyclosporine was administered to 126 (77.3%) of tacrolimus in transplant patients and 21 (12.88%). Immediately after the transplant, patients were classified into two groups: patients with high risk of developing ERA and patients without kidney problems. At first they were introduced to the CNI from the third day after transplantation and the last six to 18 hours after the transplant, a dose that was gradually increased

Conclusions: late and gradual introduction of CNi could be an effective strategy to reduce the incidence of acute renal disease in liver transplantation