PMID- 32117698
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220413
IS  - 2231-5047 (Print)
IS  - 2231-5128 (Electronic)
IS  - 2231-5047 (Linking)
VI  - 9
IP  - 2
DP  - 2019 Jul-Dec
TI  - Update on Immunosuppression in Liver Transplantation.
PG  - 96-101
LID - 10.5005/jp-journals-10018-1301 [doi]
AB  - The standard therapy for decompensated end-stage chronic liver disease of any 
      etiology and acute fulminant hepatic failure is liver transplantation (LT). 
      Advances in immunosuppressive therapy decreased the rates of acute and chronic 
      rejections. Thus, graft and patient survivals have significantly improved. 
      However, long-term adverse effects of prolonged use of immunosuppressive agents 
      such as malignancies, opportunistic infections, metabolic disorders, and other 
      organ toxicities have now become a major concern. Consequently, alternative 
      approaches are needed to deescalate the customary drugs and their side effects. 
      Therapy must be individualized and additional preventive measures should be taken 
      by patients with particular risk factors or predisposed to certain adverse 
      effects. Current opinion favors a combination of agents with different mechanism 
      of actions and toxicity profiles. Corticosteroids are employed in immediate and 
      early postoperative period. Although they have a pronounced side effect profile, 
      calcineurin inhibitors (CNIs) are still the backbone of early and late phase 
      immunosuppressive regimens because of their proved efficacy. Antimetabolites are 
      frequent choices for steroid and/or CNI-sparing strategies. Studies also have 
      established a role for mammalian target of rapamycin (mTOR) inhibitors in 
      specific groups of recipients. Biologic agents are a hot topic of interest and 
      made their way into current strategies for induction. Agents extrapolated from 
      other transplantation or immunologic experience are being evaluated. HOW TO CITE 
      THIS ARTICLE: Tasdogan BE, Ma M, Simsek C, et al. Update on Immunosuppression in 
      Liver Transplantation. Euroasian J Hepato-Gastroenterol 2019;9(2):96-101.
CI  - Copyright (c) 2019; Jaypee Brothers Medical Publishers (P) Ltd.
FAU - Tasdogan, Burcak E
AU  - Tasdogan BE
AD  - Department of Gastroenterology and Hepatology, The Johns Hopkins University 
      School of Medicine, Baltimore, Maryland, USA.
FAU - Ma, Michelle
AU  - Ma M
AD  - Department of Gastroenterology and Hepatology, The Johns Hopkins University 
      School of Medicine, Baltimore, Maryland, USA.
FAU - Simsek, Cem
AU  - Simsek C
AD  - Department of Gastroenterology and Hepatology, The Johns Hopkins University 
      School of Medicine, Baltimore, Maryland, USA.
FAU - Saberi, Behnam
AU  - Saberi B
AD  - Department of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, 
      USA.
FAU - Gurakar, Ahmet
AU  - Gurakar A
AD  - Department of Gastroenterology and Hepatology, The Johns Hopkins University 
      School of Medicine, Baltimore, Maryland, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - India
TA  - Euroasian J Hepatogastroenterol
JT  - Euroasian journal of hepato-gastroenterology
JID - 101577625
PMC - PMC7047305
OTO - NOTNLM
OT  - Adverse effects
OT  - Immunosuppression
OT  - Liver transplantation
COIS- Source of support: Nil Conflict of interest: None
EDAT- 2020/03/03 06:00
MHDA- 2020/03/03 06:01
PMCR- 2019/07/01
CRDT- 2020/03/03 06:00
PHST- 2020/03/03 06:00 [entrez]
PHST- 2020/03/03 06:00 [pubmed]
PHST- 2020/03/03 06:01 [medline]
PHST- 2019/07/01 00:00 [pmc-release]
AID - 10.5005/jp-journals-10018-1301 [doi]
PST - ppublish
SO  - Euroasian J Hepatogastroenterol. 2019 Jul-Dec;9(2):96-101. doi: 
      10.5005/jp-journals-10018-1301.