Der klinische Stellenwert von Mycophenolat Mofetil (Cell CeptÒ) als Immunsuppressivum an der Lebertransplantationsambulanz der Klinik für Innere Medizin der Universitätsklinik Innsbruck
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Philipps-Universität Marburg
Abstract
This study was supposed to find out whether there
is a clinical relevance for MMF as immunosuppressant at the
livertransplantation outpatient clinic of the University
Hospital Innsbruck or not. To be able to do so different fields
of use of MMF were analysed: 1. MMF as rescue therapy to treat
acute rejection episodes (primary rescue) 2. MMF to control
Cyclosporine or Tacrolimus induced nephrotoxicity (secondary
rescue) 3. MMF as immunosuppressant for Hepatitis C Patients
? is there antiviral potential ? 4. Adverse effects and
limitations of use The data collected in this study and
literature data comes to following conclusions: 1. There is a
relevance of MMF in rescue treatment of acute reaction episodes
in liver transplant patients. It was shown that it is possible
to control at least mild rejection episodes without steroid
pulse therapy. Chronic rejection episode seem to react
positively to MMF treatment, but were not controllable to the
full extent. Due to very little numbers this study can only
provide very weak data regarding chronic rejection. 2.
Nephrotoxic side effects of the calcineurin inhibitors
Cyclosporine and Tacrolimus can be controlled if not reversed
by the use of MMF. Especially patients who have not been long
under the calcineurin inhibitors seem to have the biggest
profit of this treatment. It is shown that MMF allows an
immunologically safe reduction of the calcineurin inhibitors
with subsequent stable improvement of renal function. 3. The
study can not clearly answer whether there is a virustatic
effect on the Hepatitis C virus of MMF or not. We could show
that even under intensified immunosuppression with MMF there is
no increase in virus replication. In combination with
literature data this should be a strong motivation to answer
this question in further studies. 4. Adverse effects of MMF are
mainly nausea and vomiting and diarrhoea. Dose reduction could
control them.
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This item has been published with the following license: In Copyright