TY - JOUR
T1 - Protocolo de inmunosupresión en trasplante hepático: revisión de la literatura
AU - Gonzalez Dominguez, Esteban Horacio
AU - Cordova Reyes, Diego Andres
AU - Abad Polo, Paula Gabriela
AU - Eduardo González, Juan
AU - Gonzalez Dominguez, Camila Maria
AU - Cordero Velastegui, Juan Jose
AU - Flores Siguenza, Luis Francisco
AU - Aguirre Bermeo, Hernan Marcelo
PY - 2022
Y1 - 2022
N2 - Liver transplantation is the last option for the treatment of liver disease. Immunosuppression schemes
are required to avoid graft rejection, which have evolved over the years. A literature review was
carried out in PubMed on the immunosuppressive therapies available to avoid graft rejection in liver
transplantation, as well as on the schemes used, adverse effects, interactions and their modifications
from the induction phase to subsequent follow-up. The usual induction was found to be with steroids
or clonal immune therapy. In maintenance, calcineurin inhibitors are the most widely used, and their
doses should be adjusted according to their serum levels and the presence of adverse effects such
as nephrotoxicity or diabetes. On the other hand, mTOR inhibitors have been considered to reduce
the risk of hepatocellular cancer recurrence. The characteristics of the patient and their comorbidities
(pregnancy, kidney failure, diabetes, sepsis, hepatocellular carcinoma) require modification and
individualization of the treatment
AB - Liver transplantation is the last option for the treatment of liver disease. Immunosuppression schemes
are required to avoid graft rejection, which have evolved over the years. A literature review was
carried out in PubMed on the immunosuppressive therapies available to avoid graft rejection in liver
transplantation, as well as on the schemes used, adverse effects, interactions and their modifications
from the induction phase to subsequent follow-up. The usual induction was found to be with steroids
or clonal immune therapy. In maintenance, calcineurin inhibitors are the most widely used, and their
doses should be adjusted according to their serum levels and the presence of adverse effects such
as nephrotoxicity or diabetes. On the other hand, mTOR inhibitors have been considered to reduce
the risk of hepatocellular cancer recurrence. The characteristics of the patient and their comorbidities
(pregnancy, kidney failure, diabetes, sepsis, hepatocellular carcinoma) require modification and
individualization of the treatment
KW - Trasplante de hígado; Inmunosupresión ; Inmunoterapia; Rechazo de injerto; Inhibidores; Calcineurina; Rapamicina; Esteroides
KW - Trasplante de hígado; Inmunosupresión ; Inmunoterapia; Rechazo de injerto; Inhibidores; Calcineurina; Rapamicina; Esteroides
UR - https://revistahepatologia.org/index.php/hepa/article/view/48
U2 - 10.52784/27112330.147
DO - 10.52784/27112330.147
M3 - Artículo
JO - Hepatología
JF - Hepatología
ER -