{"id":2043,"date":"2016-10-01T01:00:00","date_gmt":"2016-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/impact-de-larret-des-anticalcineurines-au-profit-dune-monotherapie-par-mycophenolate-mofetil-en-transplantation-hepatique\/"},"modified":"2018-10-20T18:40:19","modified_gmt":"2018-10-20T16:40:19","slug":"impact-de-larret-des-anticalcineurines-au-profit-dune-monotherapie-par-mycophenolate-mofetil-en-transplantation-hepatique","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/impact-de-larret-des-anticalcineurines-au-profit-dune-monotherapie-par-mycophenolate-mofetil-en-transplantation-hepatique\/","title":{"rendered":"Impact de l\u2019arr\u00eat des anticalcineurines au profit d\u2019une monoth\u00e9rapie par Mycophenolate mofetil en transplantation h\u00e9patique"},"content":{"rendered":"<p><strong>2016<\/strong><\/p>\n<p><em>Juliette VERLYNDE* **, Guillaume LASSAILLY** et S\u00e9bastien DHARANCY**<br \/>\n*Centre Hospitalier de Dunkerque, Service d\u2019H\u00e9pato-Gastro-Ent\u00e9rologie<br \/>\n**CHRU de Lille, Service des Maladies de l\u2019Appareil Digestif, Unit\u00e9 de Transplantation H\u00e9patique<\/em><\/p>\n<p><strong>H\u00e9patologie <\/strong>&#8211; \u00a02016-03-28 &#8211;\u00a0 &#8211;<\/p>\n<p>________________________________<\/p>\n<p>Introduction: Les anticalcineurines (ACN) sont pourvoyeurs d\u2019insuffisance r\u00e9nale chronique. Leur arr\u00eat au profit d\u2019une monoth\u00e9rapie par Mycophenolate mofetil (MMF) est controvers\u00e9 du fait du risque de rejet. Le dosage, au moyen d\u2019une aire sous la courbe (AUC) bayesienne, de l\u2019acide mycoph\u00e9nolique (MPA) permettrait d\u2019en r\u00e9duire les risques. L\u2019objectif de cette \u00e9tude est d\u2019\u00e9valuer l\u2019efficacit\u00e9, la tol\u00e9rance et le b\u00e9n\u00e9fice de la monoth\u00e9rapie MMF au d\u00e9cours de la transplantation h\u00e9patique (TH).<br \/>\nM\u00e9thodes: Entre 2000 et 2014, les patients ayant des effets ind\u00e9sirables s\u00e9v\u00e8res des ACN ont \u00e9t\u00e9 inclus dans une \u00e9tude prospective \u00e9valuant la monoth\u00e9rapie MMF. Avant l\u2019arr\u00eat des ACN, la posologie du MMF \u00e9tait adapt\u00e9e pour atteindre une AUC cible de 45\u00b5g.h\/mL. Les donn\u00e9es cliniques et biologiques \u00e9taient recueillies \u00e0 l\u2019arr\u00eat des ACN, \u00e0 1 mois puis tous les ans pendant 5 ans. Les crit\u00e8res de jugement \u00e9taient : le rejet, le bilan h\u00e9patique, la tol\u00e9rance du MMF et l\u2019\u00e9volution de la fonction r\u00e9nale.<br \/>\nR\u00e9sultats: 122 patients ont \u00e9t\u00e9 inclus. La cause de la TH \u00e9tait l\u2019alcool dans 76% des cas. La monoth\u00e9rapie \u00e9tait r\u00e9alis\u00e9e en moyenne 6,2\u00b13,8 ans apr\u00e8s la TH. La principale cause d\u2019arr\u00eat des ACN \u00e9tait la n\u00e9phrotoxicit\u00e9. L\u2019AUC moyenne \u00e9tait de 47,3\u00b117 \u00b5g.h\/mL. 5 patients ont pr\u00e9sent\u00e9 un rejet aigu (4%). Un an apr\u00e8s arr\u00eat des ACN, il n\u2019existait pas de modification des ASAT, ALAT, bilirubine, GGT, et des leucocytes. A 1 an, la fonction r\u00e9nale s\u2019am\u00e9liorait significativement dans l\u2019ensemble de la cohorte mais \u00e9galement chez les patients avec clairance &#8804;60 et &#8804;30mL\/kg\/min. Le b\u00e9n\u00e9fice r\u00e9nal \u00e9tait conserv\u00e9 pendant 5 ans. Les patients avec un syndrome m\u00e9tabolique n\u2019am\u00e9lioraient pas leur fonction r\u00e9nale.<br \/>\nConclusion: La monoth\u00e9rapie MMF au d\u00e9cours de la TH est s\u00fbre chez des transplant\u00e9s stables, \u00e0 distance de la greffe et lorsqu\u2019une AUC cible de 45 \u00b5g.h\/mL est atteinte avant l\u2019arr\u00eat des ACN. Le risque de rejet est faible. La fonction r\u00e9nale s\u2019am\u00e9liore significativement et durablement.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2016 Juliette VERLYNDE* **, Guillaume LASSAILLY** et S\u00e9bastien DHARANCY** *Centre Hospitalier de Dunkerque, Service d\u2019H\u00e9pato-Gastro-Ent\u00e9rologie **CHRU de Lille, Service des Maladies de l\u2019Appareil Digestif, Unit\u00e9 de Transplantation H\u00e9patique H\u00e9patologie &#8211; \u00a02016-03-28 &#8211;\u00a0 &#8211; ________________________________ Introduction: Les anticalcineurines (ACN) sont pourvoyeurs d\u2019insuffisance r\u00e9nale chronique. Leur arr\u00eat au profit d\u2019une monoth\u00e9rapie par Mycophenolate mofetil (MMF) est controvers\u00e9 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[27],"class_list":["post-2043","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-27"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Impact de l\u2019arr\u00eat des anticalcineurines au profit d\u2019une monoth\u00e9rapie par Mycophenolate mofetil en transplantation h\u00e9patique - Abstracts des congr\u00e8s de l&#039;ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/impact-de-larret-des-anticalcineurines-au-profit-dune-monotherapie-par-mycophenolate-mofetil-en-transplantation-hepatique\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Impact de l\u2019arr\u00eat des anticalcineurines au profit d\u2019une monoth\u00e9rapie par Mycophenolate mofetil en transplantation h\u00e9patique - 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