Browsing by Author "Flores Siguenza, Luis Francisco"

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    Protocolo de inmunosupresión en trasplante hepático: revisión de la literatura.
    (2022) Gonzalez Dominguez, Esteban Horacio; Cordova Reyes, Diego Andres; Abad Polo, Paula Gabriela; González, Eduardo; Gonzalez Dominguez, Camila Maria; Cordero Velastegui, Juan Jose; Flores Siguenza, Luis Francisco; Aguirre Bermeo, Hernan Marcelo
    Liver transplantation is the last option for the treatment of liver disease. Immunosuppression schemes are required to avoid graft rejection, which have evolved over the years. A literature review was carried out in PubMed on the immunosuppressive therapies available to avoid graft rejection in liver transplantation, as well as on the schemes used, adverse effects, interactions and their modifications from the induction phase to subsequent follow-up. The usual induction was found to be with steroids or clonal immune therapy. In maintenance, calcineurin inhibitors are the most widely used, and their doses should be adjusted according to their serum levels and the presence of adverse effects such as nephrotoxicity or diabetes. On the other hand, mTOR inhibitors have been considered to reduce the risk of hepatocellular cancer recurrence. The characteristics of the patient and their comorbidities (pregnancy, kidney failure, diabetes, sepsis, hepatocellular carcinoma) require modification and individualization of the treatment