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Felli E, Vennarecci G, Colasanti M, et al. Early introduction of everolimus immunosuppressive regimen in liver transplantation with extra-anatomic aortoiliac-hepatic arterial graft anastomosis. Case Rep Transplant. 2014;2014:493095doi: 10.1155/2014/493095.
Felli, E., Vennarecci, G., Colasanti, M., Santoro, R., de Werra, E., Scotti, A., Burocchi, M., Levi Sandri, G. B., Campanelli, A., Lepiane, P., & Ettorre, G. M. (2014). Early introduction of everolimus immunosuppressive regimen in liver transplantation with extra-anatomic aortoiliac-hepatic arterial graft anastomosis. Case reports in transplantation, 2014493095. https://doi.org/10.1155/2014/493095
Felli, Emanuele, et al. "Early introduction of everolimus immunosuppressive regimen in liver transplantation with extra-anatomic aortoiliac-hepatic arterial graft anastomosis." Case reports in transplantation vol. 2014 (2014): 493095. doi: https://doi.org/10.1155/2014/493095
Felli E, Vennarecci G, Colasanti M, Santoro R, de Werra E, Scotti A, Burocchi M, Levi Sandri GB, Campanelli A, Lepiane P, Ettorre GM. Early introduction of everolimus immunosuppressive regimen in liver transplantation with extra-anatomic aortoiliac-hepatic arterial graft anastomosis. Case Rep Transplant. 2014;2014:493095. doi: 10.1155/2014/493095. Epub 2014 Sep 21. PMID: 25309771; PMCID: PMC4189775.
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Case Rep Transplant. 2014;2014:493095. doi: 10.1155/2014/493095. Epub 2014 Sep 21.

Early introduction of everolimus immunosuppressive regimen in liver transplantation with extra-anatomic aortoiliac-hepatic arterial graft anastomosis.

Case reports in transplantation

Emanuele Felli, Giovanni Vennarecci, Marco Colasanti, Roberto Santoro, Edoardo de Werra, Andrea Scotti, Mirco Burocchi, Giovanni B Levi Sandri, Alessandra Campanelli, Pasquale Lepiane, Giuseppe M Ettorre

Affiliations

  1. Digestive and Transplant Liver Surgery Unit, S. Camillo Hospital, Piazza Carlo Forlanini 1, 00151 Rome, Italy.

PMID: 25309771 PMCID: PMC4189775 DOI: 10.1155/2014/493095

Abstract

Liver transplantation is the treatment of choice for patients with acute and chronic end-stage liver disease, when no other medical treatment is possible. Despite high rates of 1- to 5-year survival, long-term adverse effects of immunosuppressant agents remain of major concern. Current research and clinical efforts are made to develop immunosuppressant agents that minimize adverse effects along with a low rate of graft rejection. Tailoring immunosuppressive therapy to individual patients by the use of proliferation signal inhibitors seems to be the best way to minimize toxicity and increase efficacy. Recently everolimus has been introduced in clinical practice; among its adverse effects an increased incidence of arterial graft thrombosis in renal transplants, vascular anastomosis leakage, impaired wound healing, and thrombotic microangiopathy have been reported. We present the case of a 54-year-old patient submitted to liver transplantation for end-stage liver disease treated by an extra-anatomic aortoiliac-hepatic arterial graft anastomosis and early postoperative introduction of everolimus for acute renal failure. Postoperative period was characterized by two abdominal collections and reactivation of cytomegalovirus infection that were treated by percutaneous drainage and antiviral therapy, respectively; the patient is well after 8-month followup with patency of the arterial conduit and no leakage.

References

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