Management of immunosuppressant agents following liver transplantation: Less is more

World Journal of Hepatology
Mustafa S AschaIbrahim A Hanouneh

Abstract

Immunosuppression in organ transplantation was revolutionary for its time, but technological and population changes cast new light on its use. First, metabolic syndrome (MS) is increasing as a public health issue, concomitantly increasing as an issue for post-orthotopic liver transplantation patients; yet the medications regularly used for immunosuppression contribute to dysfunctional metabolism. Current mainstay immunosuppression involves the use of calcineurin inhibitors; these are potent, but nonspecifically disrupt intracellular signaling in such a way as to exacerbate the impact of MS on the liver. Second, the impacts of acute cellular rejection and malignancy are reviewed in terms of their severity and possible interactions with immunosuppressive medications. Finally, immunosuppressive agents must be considered in terms of new developments in hepatitis C virus treatment, which undercut what used to be inevitable viral recurrence. Overall, while traditional immunosuppressive agents remain the most used, the specific side-effect profiles of all immunosuppressants must be weighed in light of the individual patient.

References

Dec 1, 1991·Diabetes Care·P Björntorp
Oct 27, 1994·The New England Journal of Medicine·UNKNOWN U.S. Multicenter FK506 Liver Study Group
Feb 15, 1997·The Journal of Clinical Investigation·L LuziV Mazzaferro
Mar 1, 1997·Hepatology : Official Journal of the American Association for the Study of Liver Diseases
Jan 1, 1995·Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·L R FisherM R Lucey
Jul 17, 1998·Transplant International : Official Journal of the European Society for Organ Transplantation·G TisoneC U Casciani
Sep 10, 1998·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·R H WiesnerK M Detre
Aug 3, 1999·Transplant International : Official Journal of the European Society for Organ Transplantation·C A SeilerJ Reichen
Mar 4, 2000·The New England Journal of Medicine·S HariharanD Stablein
Jul 6, 2000·Immunopharmacology·A C Allison, E M Eugui
May 12, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·J F TrotterG Everson
May 23, 2001·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·J M MoralesJ L Rodicio
Aug 18, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·J D EasonA L Mason
Sep 12, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·J PruthiT L Fong
Nov 2, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·J J FungB Eghtesad
Jan 12, 2002·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Satheesh NairPaul J Thuluvath
May 31, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Roberta VolpinAngelo Gatta
May 31, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sarah Goddard, David H Adams
Oct 3, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Stefano BrillantiAntonino Cavallari
Oct 22, 2002·American Journal of Physiology. Renal Physiology·Jennifer L GoochHanna E Abboud
Dec 11, 2002·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Adam S BartlettJohn L McCall
Jan 25, 2003·Transplantation·Ulf P NeumannPeter Neuhaus
May 14, 2003·Transplantation Proceedings·S N Sehgal
May 14, 2003·Transplantation Proceedings·J D MorrisettB D Kahan
Aug 26, 2003·Journal of the American Society of Nephrology : JASN·Greg A KnollCarl Van Walraven
Oct 31, 2003·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Edward Gane
Feb 10, 2004·Arteriosclerosis, Thrombosis, and Vascular Biology·Scott M GrundyUNKNOWN American Heart Association
Nov 24, 2004·Nutrition, Metabolism, and Cardiovascular Diseases : NMCD·G AnfossiM Trovati
Dec 24, 2004·The New England Journal of Medicine·Philip F Halloran
Jan 13, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Marcus BahraPeter Neuhaus

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Citations

Jun 21, 2018·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Avash KalraLisa M Forman
Jan 17, 2019·Scandinavian Journal of Gastroenterology·Mohamad HanounehIbrahim A Hanouneh
Feb 25, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Katelynn Madill-ThomsenPhilip F Halloran
Jan 4, 2021·Journal of Molecular Medicine : Official Organ of the Gesellschaft Deutscher Naturforscher Und Ärzte·Chenxia HuLanjuan Li

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