Background. Clinical operational tolerance was defined as stable normal graft function in the total absence immunosuppression (IS). It may be achieved in up to 20% of liver transplant (LT) recipients. In this observational prospective study we report the outcome of long-term sustained IS avoidance after LT.
Methods. Twenty-two LT recipients (mean age: 68±5.8 years, M/F: 17/5) transplanted at our institution were completely withdrawn from IS. At weaning start, the median follow up from LT was 126±43.9 months. Nine recipients (40.9%) were withdrawn from mycophenolate mofetil and 13 (59%) from calcineurin inhibitors. The median time of weaning process was 7±3.4 months. Liver function tests, renal and metabolic parameters were compared before and after weaning. Evolution and/or new onset of comorbidities were also evaluated during the study period.
Results. The median follow-up of IS weaning was 64±43 months. All patients were alive and in good clinical status. None experienced graft rejection. No difference in terms of liver function (p=0.71), renal function (p=0.82) and lipid profile (p=0.29) were observed over the follow up period. None experienced comorbidities.
Conclusion. IS withdrawal once established seems to be durable and safe for the LT recipients.
To cite this abstract in AMA style:Manzia T, Angelico R, Toti L, Fazzolari L, Tariciotti L, Sforza D, Manuelli M, Tognoni V, Di A, Tisone G. Long Term Clinical Outcome of Liver Transplant Recipients Who Successfully Withdrawn Immunosuppression, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/long-term-clinical-outcome-of-liver-transplant-recipients-who-successfully-withdrawn-immunosuppression-the/. Accessed November 24, 2017.
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