PRIMARY INDUCTION WITH MYCOPHENOLATE MOFETIL AND CORTICOSTEROIDS IN ALIVER-TRANSPLANT RECIPIENT WITH HEPATORENAL-SYNDROME

OBJECTIVE: To report the use of mycophenolate mofetil for primary indu ction in a liver transplant recipient to avoid the nephrotoxicity of c yclosporine/tacrolimus. CASE SUMMARY: A 47-year-old white man in hepat ic coma with anuric hepatorenal syndrome received a liver transplant, and was given mycophenolate mofetil and corticosteroids as primary ind uction immunosuppression with the addition of low-dose cyclosporine 13 days later. His renal function improved and he remains rejection-free after 13 months of follow-up. CONCLUSIONS: This case suggests that my cophenolate mofetil may be used as a primary induction agent in liver transplant recipients with renal failure to avoid the additional nephr otoxicity of the standard immunosuppressants, cyclosporine and tacroli mus. Low-dose cyclosporine/tacrolimus may be introduced later as the r enal function improves.