The association between MMF and risk of progressive renal dysfunction and death in adult liver transplant recipients with HCV

John R Lake, Dharmesh Patel, Kristin David, Jason Richwine, Jonathan Morris

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

The impact of a three-drug regimen including mycophenolate mofetil (MMF) vs. a two-drug (no MMF) regimen on progressive renal dysfunction (PRD) in liver transplant recipients with hepatitis C virus (HCV) infection has not been well described. Adults with HCV who received a primary liver transplant between January 1, 2000 and December. 31, 2005 and were discharged from the hospital on a three-drug regimen [CNI+MMF+steroids (S)] (n = 4946) were compared with those discharged on two-drug regimen (CNI+S) (n = 3884). Time to PRD (defined by a post-transplant 25% decline in estimated GFR, based on the four-variable MDRD equation) and recipient death were evaluated using Kaplan-Meier analysis. Cox proportional hazards regression was used to estimate the risk for post-transplant PRD and death after controlling for baseline characteristics and extended steroid use. The two groups were similar in baseline characteristics. The percentage of recipients on three- vs. two-drug regimen without PRD was higher, 36.8% vs. 31.9%, (p < 0.001), at three yrs post-transplant; three-drug therapy was associated with a 6% lower adjusted risk of PRD. The death rate and adjusted risk for death was lower for recipients on a three- vs. two-drug regimen. Liver transplant recipients with HCV on a MMF-containing regimen are at a lower risk for PRD and death compared with recipients on a regimen not including MMF.

Original languageEnglish (US)
Pages (from-to)108-115
Number of pages8
JournalClinical Transplantation
Volume23
Issue number1
DOIs
StatePublished - Apr 3 2009

Keywords

  • Chronic kidney disease
  • Hepatitis C
  • Immunosuppression
  • Liver transplantation
  • Mycophenolate mofetil

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