Abstract:

Objective To investigate the long-term efficacy of mycophenolic acid monotherapy in liver transplantation recipients. Methods The clinical data of 30 liver transplantation recipients in the Third Medical Center of PLA General Hospital from September 2002 to August 2020 were retrospectively analyzed. These patients were convertedfrom CNI regimen to MPA （CNI free） regimen due to toxicity， and their liver and kidney functions and adverse effectwerecompared before and after the conversion. The follow-up period was 2 years. Results The creatinine（Cr） levels at 1 and 2 years after conversion were （83.5±24.3）μmol/L and （74.2±15.9）μmol/L， respectively. The Cr level was significantly lower than that before conversion （P ＜ 0.05）. The estimated glomerular filtration rate （eGFR） was （77.7±9.1）ml/min and （86.1±6.5）ml/min， respectively. The eGFR level was significantly increased（P ＜ 0.05）. The alanine aminotransferase （ALT），aspartate aminotransferase（AST） and total bilirubin（TBil） levels had no significant changes before and after conversion（ALL P ＞ 0.05）. Conclusion The efficacy of mycophenolic acid monotherapy in long-term recipients of liver transplantation is worth affirming. 

Key words:

 , Liver transplantation； Mycophenolic acid； Long-term effect； Calcineurin inhibitor toxicity

摘要：

目的 探讨肝移植受者术后单用霉酚酸（mycophenolic acid，MPA）类药物的远期疗效。方法回顾性分析 2002 年 9 月至 2021 年 8 月期间解放军总医院第三医学中心 30 例肝移植受者临床资料，上述病例从钙调磷酸酶抑制剂（calcineurin inhibitor，CNI）方案因肾毒性转换为单药霉酚酸类药物免 CNI 类方案，并对转换前后肝功能、肾功能以及其不良反应进行对比分析，随访周期为 2 年。结果 转换后 1 年与转换后 2 年的肌酐（creatinine，Cr）水平分别为（83.5±24.3）μmol/L、（74.2±15.9）μmol/L。估算的肾小球滤过率（estimated glomerular filtration rate，eGFR）分别为（77.7±9.1）ml/min、（86.1±6.5）ml/min。与转换前比较，Cr 水平明显 降低（P ＜ 0.05），eGFR 水平得到明显提高（P ＜ 0.05）。丙氨酸转氨酶（alanine aminotransferase，ALT）、天冬氨酸转氨酶（aspartate aminotransferase，AST）、总胆红素（total bilirubin，TBil）水平前后无明显变化（均 P ＞0.05）。结论 肝移植远期的受者霉酚酸类药物单药维持，其安全性值得肯定，无明显不良反应，且其肾功能 水平可从免 CNI 抗排斥方案中获益。 

关键词:

肝移植 , 霉酚酸 , 远期疗效 , 钙调磷酸酶抑制剂毒性