CNI Minimization in Liver Transplant Patients
Author Information
Author(s): Kong Yuan Wang, Dongping Shang, Yushu Liang, Wenhua Ling, Xiaoting Guo, Zhiyong He, He Xiaoshun
Primary Institution: Organ Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
Hypothesis
Can calcineurin-inhibitor (CNI) minimization protocols improve renal function in liver transplant recipients with CNI-related renal dysfunction?
Conclusion
CNI minimization can preserve or even improve renal function in liver transplant patients with renal impairment, while sharing similar short term acute rejection rate and patient survival with routine CNI regimen.
Supporting Evidence
- GFR was significantly improved in the CNI minimization group compared to the routine CNI regimen group.
- sCr level was significantly lower in the CNI minimization group.
- CrCl was not significantly higher in the CNI minimization group.
- Acute rejection episodes were comparable between the two groups.
- Patient survival rates were similar between CNI minimization and routine CNI regimen.
- CNI minimization protocols may be related to a higher incidence of infections.
Takeaway
This study found that using less of a certain medicine (CNI) can help kidney function in liver transplant patients without causing more problems.
Methodology
A meta-analysis of randomized trials and observational studies comparing renal function in liver transplant patients on CNI minimization versus routine CNI regimen.
Potential Biases
High risk of bias due to lack of double-blinding and intention-to-treat analysis in most studies.
Limitations
The included studies had varying protocols and short follow-up durations, which may affect the generalizability of the results.
Participant Demographics
Included 32 trials with a total of 1383 patients, with varying demographics across studies.
Statistical Information
P-Value
p<0.00001
Confidence Interval
95% CI
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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