Affiliation:
1. Department of Surgery, Graduate School of Medicine Kyoto University Kyoto Japan
2. Department of Hepato‐Biliary‐Pancreatic Surgery and Transplantation Kanazawa University Kanazawa Japan
3. Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences Himeji Dokkyo University Himeji Japan
4. Department of Diagnostic Pathology Kyoto University Hospital Kyoto Japan
Abstract
AbstractBackground/PurposeThis experimental study in rats aimed to investigate the impact of very early introduction (within 3 h) of everolimus (EVR) + reduced‐tacrolimus (TAC) after partial liver transplantation (LT) on liver regeneration, rejection, and survival.MethodsBased on appropriate dose of EVR + reduced‐TAC in 70% hepatectomy (Experiment 1), allogeneic 30% partial LT (Experiment 2) and whole LT (Experiment 3) were performed.ResultsAfter partial LT in EVR + reduced‐TAC therapy, restoration of liver graft weight (to that of the whole liver) was delayed compared with standard dose TAC monotherapy (standard‐TAC) on day 3 (59.3% vs. 72.9%; p < .001) and 14 (88.1% vs. 95.5%; p = .01). Survival was 75%, which was not as high as the value of 100% observed for standard‐TAC, because neither infection nor rejection could be prevented. By contrast, survival after whole LT was 100% as neither infection nor rejection occurred.ConclusionsThe very early introduction of EVR + reduced‐TAC after partial LT delayed liver regeneration, and made it difficult to manage the dose required to suppress both infection and rejection. On the other hand, EVR + reduced‐TAC could be introduced safely very early after whole LT.