Surgery: Current Research

ISSN - 2161-1076

Older immunosuppressive agents: Newer approach in liver transplant recipients

International Conference and Exhibition on Surgery, Anesthesia & Trichology

November 26-28, 2012 Hilton San Antonio Airport, USA

Ashokkumar B. Jain

Scientific Tracks Abstracts: Surgery Curr Res

Abstract :

Combined Calcineurin Inhibitors (CI), antiproliferative agents & steroids is now standard immunosuppression post-liver- transplantation. Though acute rejection is uncommon nowadays, it is not eradicated. Renal dysfunction is frequent both pre- and post-transplantation. CIs, known nephrotoxic agents, when included in immunosuppressive cocktails after complicated surgery, with drastic intra-operative hemodynamic changes, only worsen renal impairment. Oral absorption of Mycophenolate Mofetil (MMF) is <50% in initial weeks after liver transplantation. Intravenous (IV) MMF achieves 100% bioavailability, permitting delayed CI introduction. This combination with standard dose steroids, we have not experienced new onset renal failure. Furthermore, preexisting hepato-renal dysfunction resolved in all cases. A low rate of (<10%) of acute cellular rejection was observed, which were readily reversed with 0.5 to 1.5 gm of methyl prednisolone.

Biography :

Ashokkumar Jain, with 25 years experience in Liver Transplantation, graduated from T.N. Medical College, Bombay, India. Masters in Surgery from Bombay University. Surgical training, UK. At University of Pittsburg, USA, mentored by Thomas Starzl, who performed first successful human liver transplantation. Faculty at Pittsburg for 14 years, then at University of Rochester. Presently Director, Liver Transplantation, Temple University Hospital, Philadelphia, where he restarted liver transplantation after eight years. Performed over 1,500 transplants, authored over 250 articles, constant invitee in conferences worldwide. Member, journal editorial boards and advisory bodies. Made substantial contributions in immunosuppresant pharmacokinetics. Mentored generations of transplant surgeons.