Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients

The aim of this study was to evaluate the impact of a steroid-free regimen with tacrolimus and mycophenolate mofetil (modified therapy) vs. a standard regimen of tacrolimus and steroids on the cardiovascular risk score of liver transplant recipients. Patients who received a liver transplant were randomized to a modified therapy (n=58) or a standard regimen (n=59). Both groups were balanced at baseline, except for a higher prevalence of diabetes mellitus (DM) (p<0.01) and a higher serum creatinine concentration (p<0.05) in the modified therapy group. After 12months, the prevalence of new-onset DM, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, and changes in cardiovascular risk factors was similar in both groups. The increase in serum creatinine (mg/dL) compared to baseline at oneyr post-transplantation was numerically lower in the modified therapy group (0.22 +/- 0.42) than in the standard regimen group (0.41 +/- 0.67) (p=0.068). Although estimated cardiovascular risk score did not vary significantly compared to baseline in either group, there was a slight reduction in the modified regimen (-0.27 +/- 2.87) vs. a mild increase (0.17 +/- 2.94) in the standard regimen (p=0.566). In conclusion, a steroid-free regimen with tacrolimus and mycophenolate mofetil was associated with a trend toward better preservation of kidney function and reduction of cardiovascular risk score.