Publicaciones científicas
Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients
Valentín Cuervas-Mons 1 , J Ignacio Herrero 2 3 , Miguel A Gomez 4 , Ignacio González-Pinto 5 , Trinidad Serrano 6 , Manuel de la Mata 3 7 , Joan Fabregat 8 , Mikel Gastaca 9 , Itxarone Bilbao 3 10 , Evaristo Varo 11 , Gloria Sánchez-Antolín 12 , Juan Rodrigo 13 , María Dolores Espinosa
Abstract
The aim of this study was to evaluate the impact of a steroid-free regimen with tacrolimus and mycophenolate mofetil (modified therapy) vs. a standard regimen of tacrolimus and steroids on the cardiovascular risk score of liver transplant recipients.
Patients who received a liver transplant were randomized to a modified therapy (n = 58) or a standard regimen (n = 59). Both groups were balanced at baseline, except for a higher prevalence of diabetes mellitus (DM) (p < 0.01) and a higher serum creatinine concentration (p < 0.05) in the modified therapy group.
After 12 months, the prevalence of new-onset DM, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, and changes in cardiovascular risk factors was similar in both groups. The increase in serum creatinine (mg/dL) compared to baseline at one yr post-transplantation was numerically lower in the modified therapy group (0.22 ± 0.42) than in the standard regimen group (0.41 ± 0.67) (p = 0.068).
Although estimated cardiovascular risk score did not vary significantly compared to baseline in either group, there was a slight reduction in the modified regimen (-0.27 ± 2.87) vs. a mild increase (0.17 ± 2.94) in the standard regimen (p = 0.566).
In conclusion, a steroid-free regimen with tacrolimus and mycophenolate mofetil was associated with a trend toward better preservation of kidney function and reduction of cardiovascular risk score.
CITA DEL ARTÍCULO Clin Transplant. 2015 Aug;29(8):667-77. doi: 10.1111/ctr.12557.
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