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Nephrol Dial Transplant (2004) 19: IV22-IV25
Nephrol Dial Transplant Vol. 19 Suppl 4 © ERA–EDTA 2004; all rights reserved

Immunosuppression and modulation in liver transplantation

Jens Encke1, Waldemar Uhl2, Wolfgang Stremmel1 and Peter Sauer1

1 Department of Internal Medicine IV, University of Heidelberg, Bergheimerstrasse 58, 69115 Heidelberg, Germany and 2 Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany

Correspondence and offprint requests to: Jens Encke, MD, Department of Internal Medicine IV, Gastroenterology, Hepatology, Infectious Diseases, Intoxications, University of Heidelberg, Bergheimerstrasse 58, 69115 Heidelberg, Germany. Email: Jens_Encke{at}med.uni-heidelberg.de

Abstract

Recent advances in immunosuppressive drug regimens have changed the outcome after liver transplantation significantly in the last two decades. However, chronic rejection and long-term graft survival remains a major problem. Side effects like drug-induced nephrotoxicity, hypertension, osteoporosis, hyperlipidaemia and neuropathy of some immunosuppressive agents play an essential role in long-term allograft and patient survival. This review outlines the current treatment of short- and long-term immunosuppression in liver transplanted patients, it summarizes the treatment of acute and chronic rejection, describes the complications and side effects of immunosuppressive therapy and points out the current use of immunosuppressive therapy in living-related liver transplantation.

Keywords: antiproliferative agents; calcineurin inhibitors; corticosteroids; immunosuppression; liver transplantation; living-related liver transplantation


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