BACKGROUND: The long-term complications of immunosuppressive therapy such as @entity6 , @entity1007 , and @entity101 are a major source of morbidity in liver transplant recipients. In this prospective, randomized, open-label study we completely withdrew @entity229 (PRED) 14 days after liver transplantation in an effort to decrease these metabolic complications. @entity1 were maintained on @entity618 ( @entity2098 ) in combination with either @entity205 (CsA; Neoral formulation) or @entity1140 ( @entity11636 ). Thus, we also were able to compare @entity870 to @entity11636 in @entity1 not receiving PRED with respect to efficacy, @entity137 , and effect on posttransplant metabolic complications. METHODS: A total of 71 @entity1 were randomized to receive either @entity11636 - @entity2098 (n=35) or CsA- @entity2098 (n=36) after liver transplantation and were analyzed for @entity1 and graft survival. Fifty-eight @entity1 continued the immunosuppressive protocol for at least 6 months after transplantation and were analyzed for the incidence of acute rejection and the prevalence of @entity6 , @entity101 , and @entity1007 . RESULTS: The 6-month @entity1 survival rates were 94.4% for CsA- @entity2098 and 88.6% for @entity11636 - @entity2098 . Corresponding 6-month graft survival rates were 88.7% and 85.71% with no immunologic graft losses in either group. The incidence of biopsy-proven acute rejection was 46% for CsA- @entity2098 and 42.3% for @entity11636 - @entity2098 . Six @entity1 were converted from CsA to @entity11636 (four for recurrent rejection) and seven @entity1 were converted from @entity11636 to CsA (four for @entity2359 ). Only one @entity1 (in the @entity11636 - @entity2098 group) developed new-onset posttransplant @entity6 . In contrast, four of eight @entity1 in the CsA- @entity2098 group who were @entity6 before transplant became nondiabetic in the first 3 months after transplant. The mean serum @entity165 level was significantly lower in the @entity11636 - @entity2098 group than in the CsA- @entity2098 group (145.2+/-41.8 mg/dl and 190.3+/-62.2, respectively; P<0.001) and the incidence of @entity101 was lower in the @entity11636 - @entity2098 group (12% vs. 30.3% in the CsA- @entity2098 group, P<0.01). Both groups had a lower incidence of metabolic complications compared with a historical group (n=100) maintained on CsA and PRED (10 mg/day at 6 months). CONCLUSIONS: @entity2098 in combination with either @entity11636 or CsA allows withdrawal of @entity69914 days after liver transplantation with a moderate rejection rate and no immunologic graft losses. Early PRED @entity6 , @entity1007 , and @entity101 , but @entity1 maintained on @entity11636 have lower serum @entity165 levels and a lower incidence of @entity101 than CsA-treated @entity1 .

XXXX withdrawal 14 days after liver transplantation with mycophenolate: a prospective trial of @entity205 and @entity1140 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity69914 :: ('387486', 'Gene') :: ['PRED 14'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity1007 :: ('MESH:D006937', 'Disease') :: ['hypercholesterolemia'] @entity6 :: ('MESH:D003920', 'Disease') :: ['withdrawal decreases posttransplant diabetes', 'diabetic', 'diabetes'] @entity870 :: ('CHEBI:55379', 'Chemical') :: ['CsA'] @entity229 :: ('MESH:D011241', 'Chemical') :: ['prednisone'] @entity205 :: ('MESH:D016572', 'Chemical') :: ['cyclosporine'] @entity2098 :: ('CHEBI:8764', 'Chemical') :: ['MMF'] @entity165 :: ('MESH:D002784', 'Chemical') :: ['cholesterol'] @entity618 :: ('MESH:C063008', 'Chemical') :: ['mycophenolate mofetil'] @entity1140 :: ('MESH:D016559', 'Chemical') :: ['tacrolimus'] @entity11636 :: ('CHEBI:53498', 'Chemical') :: ['TAC'] @entity2359 :: ('MESH:D020258', 'Disease') :: ['neurotoxicity']
@entity229 :: (MESH:D011241,Chemical) :: ['Prednisone']
