Mycophenolate Mofetil in Liver Transplantation: a Review

4685 Words19 Pages
© Ann Transplant, 2013; 18: 685-696 DOI: 10.12659/AOT.889299 WWW.annalsoftransplantation.COM Review Paper Received: 2013.04.19 Accepted: 2013.08.10 Published: 2013.12.18 Authors’ Contribution: A Study Design B Data Collection C Statistical Analysis D Data Interpretation E Manuscript Preparation F Literature Search G Funds Collection Mycophenolate mofetil in liver transplantation: A review Alexander Kaltenborn1,2 AEF, Harald Schrem2 EF 1 2 Federal Armed Forces Medical Center Hannover, Hannover ,Germany Department of General, Visceral and Transplantation Surgery, Medizinische Hochschule Hannover, Hannover, Germany Summary Liver transplantation is the only live-saving, curative treatment for various end-stage liver diseases, and it has excellent survival rates. Mycophenolate mofetil is widely used as co-medication for immunosuppression after liver transplantation, especially to allow a sparing effect on calcineurin-inhibitors, thus reducing their numerous adverse effects. It improves both graft and patient survival. The properties of its active metabolite, mycophenolic acid, are diverse: inhibition of de novo purine synthesis and selective lymphocyte inhibition, anti-tumoral, antiviral, anti-angioneoplastic, and vasculoprotective mechanisms are described and summarized in this review. The most common adverse effects of mycophenolate mofetil are gastrointestinal complaints such as diarrhea, which often lead to dose-reduction or withdrawal of mycophenolate mofetil. A newer, enteric-coated formulation is available, which is meant to reduce the gastrointestinal adverse effects. Mycophenolate mofetil does not relevantly interact with other common drugs. The question of whether therapeutic drug monitoring allows optimized dosing strategies cannot be satisfyingly answered yet. The optimal partner-immunosuppressant seems to be tacrolimus, especially in low

More about Mycophenolate Mofetil in Liver Transplantation: a Review

Open Document