HISTOLOGICAL AND BIOCHEMICAL EFFECTS OF CYCLOSPORINE-A WITHDRAWAL FROM A TRIPLE-DRUG REGIMEN AFTER OVER 2 YEARS OF TREATMENT IN LIVER-TRANSPLANT PATIENTS

IJ KLOMPMAKER, ASH GOUW, EB HAAGSMA, MJH SLOOFF

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Abstract

Cyclosporine A was withdrawn from a triple drug immunosuppressive regimen in 10 clinically and biochemically stable liver transplant patients, This study reports the effects of cyclosporine A withdrawal on liver tests and liver histology.

Serum aspartate amino transferase and serum alanine amino transferase values increased significantly, Seven out of ten patients had histological changes after cyclosporine A withdrawal, but not before, These changes were compatible with acute rejection (consistent with rejection) in two patients and grade I also in two patients, including one patient with a second graft. Only two of these patients needed corticosteroid treatment (one consistent with rejection and one grade I rejection). Cyclosporine A treatment was restarted in three patients, because a coexisting osteoporosis prohibited prolonged corticosteroid recycling, Seven patients were able to maintain stable though slightly elevated transaminases without cyclosporine A, with a follow up of median 26 months.

Our results suggest that in stable patients cyclosporine A withdrawal can be considered, for instance 2 years after liver transplantation.

Original languageEnglish
Pages (from-to)151-157
Number of pages7
JournalJournal of Hepatology
Volume22
Issue number2
Publication statusPublished - Feb-1995

Keywords

  • CYCLOSPORINE A WITHDRAWAL
  • LIVER HISTOLOGY
  • LIVER TESTS
  • ALLOGRAFT-REJECTION
  • RENAL-FUNCTION
  • RECIPIENTS

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