everolimus after liver transplantation: Choose better-documented immunosuppressant combinations

摘要

No comparison with standard triple-drug combinations.There is no consensus immunosuppressive regimen for preventing liver graft rejection. A cortico-steroid is often combined with a calcineurin inhibitor such as tacrolimus and an antimetabolite such as mycophenolic acid (1). Everolimus antagonises mTOR protein and thereby inhibits T lymphocyte pro-liferation, leading to an immunosuppressive effect (see below). Clinical evaluation in heart and kidney transplant recipients did not show that everolimus provided an advantage over existing immunosuppressant combinations (2). Everolimus (Certican0, Novartis Pharma) is also authorised for the prevention of liver transplant rejection, in combination with a corticosteroid and tacrolimus.