5) recieved initially a combination therapy of EVR with very-low dose CSA (81.8%) or tacrolimus (18.2%).
EVR treatment was started on post op day 1, 2 and 3 in 23, 8 and 2 patients, respectively. The EVR, CSA and TAC doses were adjusted to aim at a trough target level between 3-8 ng/ml, 50-80 ng/ml and 3-5 ng/ml, respectively. Other concommittant initial immu-nosuppressive therapy included basiliximab in 13 patients (39.4%), and prednisolone in all patients. Mean follow-up was 883 days. Indications for early treatment with EVR were renal dysfunction (39.4%), prophylaxis for recurrent HCC 36.4%), neurological problems (6%), other preexisting malignancies (3%) or combined ROCK inhibitor OLT/kidney transplantation (15%). During follow-up CNI was stopped in 4/33 patients (12.1%). Altogether only 2/33 patients (6%) experienced a mild episode of BPAR (BANF score 4 and 5) 20 and 80 weeks post OLT. Both patients responded well to steroids. No patient required a retransplantation. No patient developed hepatic artery thrombosis. Impaired wound healing was an uncommon complication (9%).
The 1- and 2- year patient survival rate was 90.9% and 81.8%, respectively. HCC recurred in 2/12 patients. Post-operatively 8/27 (29.6%) OLT recipients not undergoing http://www.selleckchem.com/products/pci-32765.html kidney transplantation required dialysis. At last follow-up only 1 of these patients had terminal renal insufficiency. In 8 (24.2%) patients EVR treatment was stopped after a mean treatment duration of 311.5 days for hematological side effects (9%), infections (6%), dermatological side effects (6%), polyarthral-gia
(3%). Other side effects included hypercholesterolemia (51.5%), anemia (12.1%), leukopenia (6%), edema (3%), proteinuria (9%). During follow-up incisional hernias occurred frequently (45.4%), but rarely required surgical repair (21.2%). Conclusion: Everolimus treatment start directly post operative in combination with Glutamate dehydrogenase very low-dose CNI is effective and safe post OLT resulting in a low rejection rate. Disclosures: Martina Koch – Grant/Research Support: Novartis Lutz Fischer – Advisory Committees or Review Panels: Novartis, Gilead; Grant/ Research Support: Astellas; Speaking and Teaching: Novartis Bjoern Nashan – Advisory Committees or Review Panels: Novartis, Bristol-Myer Squibb; Speaking and Teaching: Novartis, Bristol-Myer Squibb The following people have nothing to disclose: Martina Sterneck, Antonio Galante, Gesa Pamperin, Jun Li Introduction: Young people with liver disease, aged 12-25 years, are a unique population that requires special attention with respect to adherence to treatment and their subsequent transition to adult services. Reports on long-term survival following liver transplantation (LT) show decreased patient and graft survival in young adults with non-adherence (NA) as one of the main contributory factors.