Asunto(s)
Supervivencia de Injerto/inmunología , Antígenos HLA/inmunología , Prueba de Histocompatibilidad , Trasplante de Hígado/inmunología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de TiempoAsunto(s)
Supervivencia de Injerto/inmunología , Prueba de Histocompatibilidad , Trasplante de Hígado/inmunología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Estudios de Seguimiento , Alemania , Rechazo de Injerto/epidemiología , Antígenos HLA/genética , Antígenos HLA-DR , Humanos , Lactante , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Glucemia/efectos de los fármacos , Ciclosporina/uso terapéutico , Inmunosupresores/uso terapéutico , Trasplante de Hígado/fisiología , Tacrolimus/uso terapéutico , Adulto , Glucemia/metabolismo , Péptido C/sangre , Simulación por Computador , Estudios de Seguimiento , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/sangre , Trasplante de Hígado/inmunología , Factores de TiempoAsunto(s)
Glucemia/efectos de los fármacos , Péptido C/sangre , Ciclosporina/uso terapéutico , Inmunosupresores/uso terapéutico , Insulina/metabolismo , Trasplante de Hígado/fisiología , Tacrolimus/uso terapéutico , Simulación por Computador , Ciclosporina/farmacología , Estudios de Seguimiento , Prueba de Tolerancia a la Glucosa , Humanos , Inmunosupresores/farmacología , Insulina/sangre , Secreción de Insulina , Trasplante de Hígado/inmunología , Modelos Biológicos , Tacrolimus/farmacología , Factores de TiempoRESUMEN
BACKGROUND: Cyclosporine (CsA)-associated side effects include nephrotoxicity, hypertension, neurological disorders, and hyperlipidemia. A considerable share of early and long-term posttransplant morbidity is likely to be drug related. METHODS: In 31 patients with stable graft function, conversion from CsA to tacrolimus was implemented due to nephrotoxicity (n=19), hypertension (n=9), and neurological disorders (n=8). RESULTS: Three months after conversion, a response was evident in 26 patients (84%), whereas 5 patients (16%) were nonresponsive. In 13 of 19 patients (68%) suffering from nephrotoxicity, serum creatinine levels decreased significantly from 2.0+/-0.5 mg/dl to 1.5+/-0.4 mg/dl (P<0.005), whereas in 6 of 19 patients (32%) no improvement was observed. Antihypertensive therapy was reduced in six of nine patients and neurological disorders improved in six of eight patients. When analyzing all patients, average levels of cholesterol and triglycerides were significantly lower after conversion when compared with at the time of conversion (P<0.05) CONCLUSIONS: Conversion to tacrolimus reduced drug-related side effects in the majority of patients, while graft function remained stable. Conversion to tacrolimus may be considered for CsA-related side effects as a potential beneficial approach.
Asunto(s)
Ciclosporina/efectos adversos , Inmunosupresores/uso terapéutico , Trasplante de Hígado/inmunología , Tacrolimus/uso terapéutico , Adulto , Anciano , Creatinina/sangre , Quimioterapia Combinada , Femenino , Humanos , Hiperlipidemias/inducido químicamente , Hipertensión/inducido químicamente , Inmunosupresores/efectos adversos , Riñón/patología , Masculino , Persona de Mediana Edad , Morbilidad , Enfermedades del Sistema Nervioso/inducido químicamente , Estudios Retrospectivos , Factores de TiempoRESUMEN
BACKGROUND: There is a limited amount of data regarding the estrogen receptor (ER) and progesterone receptor (PgR) status of hepatocellular carcinomas (HGCs), and the relationship between receptor status and clinicopathologic features of tumors has not been reported. METHODS: Between April 1992 and December 1993, cancerous tissues for cytosolic preparation and receptor quantification in a monoclonal solid-phase enzyme immunoassay were obtained from 28 patients undergoing resection, three patients with total hepatectomy and subsequent liver transplantation, and two patients suffering from nonresectable HCC. RESULTS: ER and PgR were detected in the HCCs of 13 (39%) and 6 patients (18%), respectively. A lower age was observed among the female patients whose receptor status was negative for ER or PgR or both, as compared with the respective receptor-positive groups. No significant differences with respect to tumor stage and grading could be observed. There was one perioperative death (3%). In patients undergoing curative resection, 1-year survival in the ER(+) group was significantly lower than in the ER(-) group (40% versus 79%, p < 0.05). The 2-year survival rates in the ER(+) and ER(-) groups were 40% and 71%, respectively. A comparable trend did not become evident for PgR(+) and PgR(-) patients. CONCLUSIONS: Our data suggest a negative effect of an ER(+) tumor on patient survival after curative resection of advanced HCC.