{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:56:35Z","timestamp":1790258195197,"version":"4.1.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2984,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2007,7]]},"abstract":"<jats:sec>\n            <jats:title>Abstract<\/jats:title>\n            <jats:p>Calcineurin inhibitors (CNIs) are the cornerstone of immunosuppression after liver transplantation. However, CNI treatment is frequently associated with chronic renal failure (CRF). The reduction or interruption of CNI may reduce renal failure. We prospectively studied 49 liver recipients treated with CNI (tacrolimus, n = 14; cyclosporine, n = 35) who secondarily developed CNI-associated CRF and for whom mycophenolate mofetil (MMF) was introduced to reduce or withdraw CNI. The creatinine clearance (CCl; 42.9 \u00b1 14 ml\/minute) increased significantly after CNI reduction (48.8 \u00b1 17 ml\/minute after 1 year, 49.9 \u00b1 18 ml\/minute after 2 years, and 58.4 \u00b1 20 ml\/minute after 3 years, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). CCl decreased during the 2 years before CNI reduction at a rate of \u22125.6 \u00b1 5 ml\/minute\/year; for the 2 years after CNI reduction, CCl increased significantly by +3.2 \u00b1 4.3 ml\/minute\/year (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.0001). Ten patients did not have improved renal function after 1 year, but the rate of decrease in CCl slowed after CNI reduction. Three parameters were identified as risk factors for unresponsiveness to CNI reduction: (1) low CCl at MMF introduction, (2) a high rate of CCl decrease during the 2 years before conversion, and (3) alcoholic cirrhosis. The type of CNI molecule used did not impair the renal response. None of the patients developed acute or chronic graft rejection after the reduction or interruption of CNI. In liver recipients with CRF, a reduction or withdrawal of CNI concomitantly with the introduction of MMF was safe and was associated with an improvement in renal function. <jats:italic toggle=\"yes\">Liver Transpt 13:1004\u20131010, 2007<\/jats:italic>. \u00a9 2007 AASLD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/lt.21170","type":"journal-article","created":{"date-parts":[[2007,6,28]],"date-time":"2007-06-28T19:18:40Z","timestamp":1183058320000},"page":"1004-1010","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":43,"title":["Long-Term Effects of Calcineurin Inhibitor Conversion to Mycophenolate Mofetil on Renal Function After Liver Transplantation"],"prefix":"10.1097","volume":"13","author":[{"given":"Caroline","family":"Cr\u00e9put","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederique","family":"Blandin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Deroure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Roche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faouzi","family":"Saliba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Charpentier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Samuel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Durrbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-12-20250124","first-page":"515","article-title":"Insights into chronic cyclosporine nephrotoxicity.","volume":"34","author":"Bennett","year":"1996","journal-title":"Int J Clin Pharmacol Ther"},{"key":"R2-12-20250124","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1056\/NEJMoa021744","article-title":"Chronic renal failure after transplantation of a nonrenal organ.","volume":"349","author":"Ojo","year":"2003","journal-title":"N Engl J Med"},{"key":"R3-12-20250124","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1097\/00007890-199211000-00021","article-title":"Cyclosporine nephrotoxicity in lung transplant recipients.","volume":"54","author":"Zaltzman","year":"1992","journal-title":"Transplantation"},{"key":"R4-12-20250124","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1097\/00007890-199703150-00009","article-title":"Cyclosporineassociated endstage nephropathy after cardiac transplantation: incidence and progression.","volume":"63","author":"Goldstein","year":"1997","journal-title":"Transplantation"},{"key":"R5-12-20250124","first-page":"1296","article-title":"Factors predictive of cyclosporineinduced nephrotoxicity: the role of cyclosporine blood levels.","volume":"22","author":"Bach","year":"1990","journal-title":"Transplant Proc"},{"key":"R6-12-20250124","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1002\/hep.1840170628","article-title":"Incidence of adverse reactions to cyclosporine after liver transplantation is predicted by the first blood level.","volume":"17","author":"Azoulay","year":"1993","journal-title":"Hepatology"},{"key":"R7-12-20250124","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1097\/00007890-198803000-00015","article-title":"An analysis of cyclosporine efficacy and toxicity after liver transplantation.","volume":"45","author":"OGrady","year":"1988","journal-title":"Transplantation"},{"key":"R8-12-20250124","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1097\/00007890-200112270-00012","article-title":"Endstage renal disease (ESRD) after orthotopic liver transplantation (OLTX) using calcineurinbased immunotherapy: risk of development and treatment.","volume":"72","author":"Gonwa","year":"2001","journal-title":"Transplantation"},{"key":"R9-12-20250124","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/00007890-199807150-00010","article-title":"Chronic renal failure following liver transplantation: a retrospective analysis.","volume":"66","author":"Fisher","year":"1998","journal-title":"Transplantation"},{"key":"R10-12-20250124","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1053\/jlts.2003.50113","article-title":"Independent risk factors and natural history of renal dysfunction in liver transplant recipients.","volume":"9","author":"Pawarode","year":"2003","journal-title":"Liver Transpl"},{"key":"R11-12-20250124","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1111\/j.1600-6143.2005.00852.x","article-title":"Renal histopathological lesions after orthotopic liver transplantation (OLT).","volume":"5","author":"Pillebout","year":"2005","journal-title":"Am J Transplant"},{"key":"R12-12-20250124","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1097\/01.TP.0000144181.47045.FE","article-title":"A randomized controlled trial of cyclosporine withdrawal in renaltransplant recipients: 15year results.","volume":"78","author":"Gallagher","year":"2004","journal-title":"Transplantation"},{"key":"R13-12-20250124","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1097\/01.TP.0000137322.65953.0A","article-title":"Early cyclosporine a withdrawal in kidneytransplant recipients receiving sirolimus prevents progression of chronic pathologic allograft lesions.","volume":"78","author":"Ruiz","year":"2004","journal-title":"Transplantation"},{"key":"R14-12-20250124","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1053\/jlts.2003.50119","article-title":"A retrospective review of sirolimus (Rapamune) therapy in orthotopic liver transplant recipients diagnosed with chronic rejection.","volume":"9","author":"Neff","year":"2003","journal-title":"Liver Transpl"},{"key":"R15-12-20250124","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1345\/aph.1E165","article-title":"Sirolimusassociated hepatotoxicity in liver transplantation.","volume":"38","author":"Neff","year":"2004","journal-title":"Ann Pharmacother"},{"key":"R16-12-20250124","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.1681\/ASN.2004100844","article-title":"Cyclosporine withdrawal from a mycophenolate mofetilcontaining immunosuppressive regimen: results of a fiveyear, prospective, randomized study.","volume":"16","author":"Abramowicz","year":"2005","journal-title":"J Am Soc Nephrol"},{"key":"R17-12-20250124","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1097\/01.TP.0000151632.21551.00","article-title":"Mycophenolate mofetil substitution for cyclosporine a in renal transplant recipients with chronic progressive allograft dysfunction: the creeping creatinine study.","volume":"79","author":"Dudley","year":"2005","journal-title":"Transplantation"},{"key":"R18-12-20250124","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1681\/ASN.2005030312","article-title":"Predictive factors of acute rejection after early cyclosporine withdrawal in renal transplant recipients who receive mycophenolate mofetil: results from a prospective, randomized trial.","volume":"16","author":"Hazzan","year":"2005","journal-title":"J Am Soc Nephrol"},{"key":"R19-12-20250124","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1111\/j.1600-6143.2004.00428.x","article-title":"Increased risk of thrombotic microangiopathy in patients receiving a cyclosporinsirolimus combination.","volume":"4","author":"Fortin","year":"2004","journal-title":"Am J Transplant"},{"key":"R20-12-20250124","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1053\/j.ajkd.2005.08.037","article-title":"Thrombotic microangiopathy in marginal kidneys after sirolimus use.","volume":"46","author":"Pelle","year":"2005","journal-title":"Am J Kidney Dis"},{"key":"R21-12-20250124","first-page":"S14","article-title":"Mycophenolate mofetil.","volume":"52","author":"Sollinger","year":"1995","journal-title":"Kidney Int(Suppl)"},{"key":"R22-12-20250124","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1093\/ndt\/gfg250","article-title":"The longterm effect of switching from cyclosporin A to mycophenolate mofetil in chronic renal graft dysfunction compared with conventional management.","volume":"18","author":"Francois","year":"2003","journal-title":"Nephrol Dial Transplant"},{"key":"R23-12-20250124","doi-asserted-by":"crossref","first-page":"1910","DOI":"10.1681\/ASN.V11101910","article-title":"A metaanalysis of immunosuppression withdrawal trials in renal transplantation.","volume":"11","author":"Kasiske","year":"2000","journal-title":"J Am Soc Nephrol"},{"key":"R24-12-20250124","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1002\/lt.500050513","article-title":"Conversion of liver transplant recipients on cyclosporine with renal impairment to mycophenolate mofetil.","volume":"5","author":"Herrero","year":"1999","journal-title":"Liver Transpl Surg"},{"key":"R25-12-20250124","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S0140-6736(00)04055-1","article-title":"Replacement of calcineurin inhibitors with mycophenolate mofetil in livertransplant patients with renal dysfunction: a randomised controlled study.","volume":"357","author":"Schlitt","year":"2001","journal-title":"Lancet"},{"key":"R26-12-20250124","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/01.TP.0000165118.00988.D7","article-title":"Mycophenolate mofetil for renal dysfunction in liver transplant recipients on cyclosporine or tacrolimus: randomized, prospective, multicenter pilot study results.","volume":"80","author":"Reich","year":"2005","journal-title":"Transplantation"},{"key":"R27-12-20250124","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/j.1432-2277.2004.tb00481.x","article-title":"Long term efficacy and safety of mycophenolate mofetil in liver transplant recipients with calcineurin inhibitorinduced renal dysfunction.","volume":"17","author":"Koch","year":"2004","journal-title":"Transpl Int"},{"key":"R28-12-20250124","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1097\/00007890-200210270-00002","article-title":"Kidney transplantation without calcineurin inhibitor drugs: a prospective, randomized trial of sirolimus versus cyclosporine.","volume":"74","author":"Flechner","year":"2002","journal-title":"Transplantation"},{"key":"R29-12-20250124","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1053\/ajkd.2001.27506","article-title":"Sirolimus and mycophenolate mofetil for calcineurinfree immunosuppression in renal transplant recipients.","volume":"38","author":"Pescovitz","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"R30-12-20250124","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1002\/lt.20903","article-title":"Mycophenolate mofetil in combination with reduction of calcineurin inhibitors for chronic renal dysfunction after liver transplantation.","volume":"12","author":"Pageaux","year":"2006","journal-title":"Liver Transpl"},{"key":"R31-12-20250124","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/S0140-6736(00)04065-4","article-title":"Mycophenolate mofetil monotherapy in liver transplantation.","volume":"357","author":"Stewart","year":"2001","journal-title":"Lancet"},{"key":"R32-12-20250124","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1046\/j.1523-1755.2002.00668.x","article-title":"Expression of TGFbeta and fibrogenic genes in transplant recipients with tacrolimus and cyclosporine nephrotoxicity.","volume":"62","author":"Khanna","year":"2002","journal-title":"Kidney Int"},{"key":"R33-12-20250124","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/j.1432-2277.2005.00115.x","article-title":"The effect of different immunosuppressive regimens on TGFbeta1 expression in kidney transplant patients.","volume":"18","author":"Matl","year":"2005","journal-title":"Transpl Int"},{"key":"R34-12-20250124","doi-asserted-by":"crossref","first-page":"S191","DOI":"10.1097\/01.tp.0000187035.22298.ba","article-title":"Review of major clinical trials with mycophenolate mofetil in renal transplantation.","volume":"80","author":"Ciancio","year":"2005","journal-title":"Transplantation"}],"container-title":["Liver Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flt.21170","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01445473-200707000-00012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T16:17:10Z","timestamp":1737735430000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01445473-200707000-00012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,7]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2007]]}},"URL":"https:\/\/doi.org\/10.1002\/lt.21170","relation":{},"ISSN":["1527-6465"],"issn-type":[{"value":"1527-6465","type":"print"}],"subject":[],"published":{"date-parts":[[2007,7]]}}}