Better actual 10-year renal transplant outcomes of 80% reduced cyclosporine exposure with sirolimus base therapy compared with full cyclosporine exposure without or with concomittant sirolimus treatment

Transplantation Proceedings

Volumn 43, Issue 10, 2011, Pages 3657-3668

  Pliszczynski, J ^a   Kahan, B D ^a  

^a UNIVERSITY OF TEXAS MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ALANINE AMINOTRANSFERASE; ASPARTATE AMINOTRANSFERASE; BASILIXIMAB; BILIRUBIN; CYCLOSPORIN A; FIBRIC ACID DERIVATIVE; HEMOGLOBIN; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LACTATE DEHYDROGENASE; LYMPHOCYTE ANTIBODY; METHYLPREDNISOLONE; OKT 3; PANEL REACTIVE ANTIBODY; PREDNISONE; RAPAMYCIN; THYMOCYTE ANTIBODY;

ADULT; AGE; ALANINE AMINOTRANSFERASE BLOOD LEVEL; ANTIBODY BLOOD LEVEL; ASPARTATE AMINOTRANSFERASE BLOOD LEVEL; BILIRUBIN BLOOD LEVEL; CADAVER DONOR; CEREBROVASCULAR ACCIDENT; CHRONIC GRAFT REJECTION; CLINICAL ASSESSMENT TOOL; CONFERENCE PAPER; CYTOMEGALOVIRUS INFECTION; DELAYED GRAFT FUNCTION; DIABETES MELLITUS; DISEASE SEVERITY; DRUG BLOOD LEVEL; DRUG DOSE REDUCTION; FEMALE; GLOMERULUS FILTRATION RATE; GRAFT RECIPIENT; GRAFT SURVIVAL; HEART ATRIUM FIBRILLATION; HEART INFARCTION; HEMOGLOBIN BLOOD LEVEL; HERPES VIRUS INFECTION; HUMAN; HYPERCHOLESTEROLEMIA; HYPERTRIGLYCERIDEMIA; IMMUNOSUPPRESSIVE TREATMENT; INCISIONAL HERNIA; KIDNEY GRAFT REJECTION; KIDNEY TRANSPLANTATION; LACTATE DEHYDROGENASE BLOOD LEVEL; LIVING DONOR; LONGITUDINAL STUDY; LYMPHOCELE; LYMPHOMA; MAJOR CLINICAL STUDY; MALE; MODIFICATION OF DIET IN RENAL DISEASE FORMULA; OUTCOME ASSESSMENT; PERITONEAL DIALYSIS; PLASMAPHERESIS; PNEUMONIA; PREDICTION; PRIORITY JOURNAL; RESPIRATORY FAILURE; RETROSPECTIVE STUDY; SEPSIS; SKIN TUMOR; SURVIVAL RATE; URINARY TRACT INFECTION; WOUND INFECTION;

ADULT; CYCLOSPORINE; DRUG THERAPY, COMBINATION; FEMALE; GRAFT REJECTION; GRAFT SURVIVAL; HUMANS; IMMUNOSUPPRESSIVE AGENTS; KAPLAN-MEIER ESTIMATE; KIDNEY TRANSPLANTATION; LINEAR MODELS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; PROPORTIONAL HAZARDS MODELS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RETROSPECTIVE STUDIES; RISK ASSESSMENT; RISK FACTORS; ROC CURVE; SIROLIMUS; STEROIDS; TIME FACTORS; TREATMENT OUTCOME;

EID: 80054737136     PISSN: 00411345     EISSN: 18732623     Source Type: Journal    
DOI: 10.1016/j.transproceed.2011.10.052     Document Type: Conference Paper

References (27)

1. H.U. Meier-Kriesche, J.D. Schold, T.R. Srinivas Lack of improvement in renal allograft survival despite a marked decrease in acute rejection rates over the most recent era Am J Transplant 4 2004 378
2. R. Marcen, J. Pascual, J.L. Teruel Outcome of cadaveric renal transplant patients treated for 10 years with cyclosporine: is chronic allograft nephropathy the major cause of late graft loss? Transplantation 72 2001 57
3. B.J. Nankivell, R.J. Borrows, C.L. Fung The natural history of chronic allograft nephropathy N Engl J Med 349 2003 2326
4. A.O. Ojo, P.J. Held, F.K. Port Chronic renal failure after transplantation of a nonrenal organ N Engl J Med 349 2003 931
5. S.N. Sehgal Sirolimus: its discovery, biological properties, and mechanism of action Transplant Proc 35 2003 7S
6. S.N. Sehgal Rapamune (RAPA, rapamycin, sirolimus): mechanism of action immunosuppressive effect results from blockade of signal transduction and inhibition of cell cycle progression Clin Biochem 31 1998 335
7. J.M. Morales, L. Wramner, H. Kreis Sirolimus does not exhibit nephrotoxicity compared to cyclosporine in renal transplant recipients Am J Transplant 2 2002 436
8. B.D. Kahan, R. Knight, L. Schoenberg Ten years of sirolimus therapy for human renal transplantation: the University of Texas at Houston experience Transplant Proc 35 2003 25S
9. G. Stallone, A. Schena, B. Infante Sirolimus for Kaposi's sarcoma in renal-transplant recipients N Engl J Med 352 2005 1317
10. B.D. Kahan Two-year results of multicenter phase III trials on the effect of the addition of sirolimus to cyclosporine-based immunosuppressive regimens in renal transplantation Transplant Proc 35 2003 37S
11. S.M. Stepkowski, L. Tian, K.L. Napoli Synergistic mechanisms by which sirolimus and cyclosporin inhibit rat heart and kidney allograft rejection Clin Exp Immunol 108 1997 63
12. D. Dindo, N. Demartines, P.A. Clavien Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey Ann Surg 240 2004 205
13. B.D. Kahan Toxicity spectrum of inhibitors of mammalian target of rapamycin in organ transplantation: etiology, pathogenesis, and treatment Expert Opinion Drug Safety 10 2011 1
14. H.U. Meier-Kriesche, B.J. Steffen, A.H. Chu Sirolimus with neoral versus mycophenolate mofetil with neoral is associated with decreased renal allograft survival Am J Transplant 4 2004 2058
15. B.D. Kahan, C. Benavides, L. Schoenberg Addition of induction therapy offsets the hazard of marked calcineurin minimization among renal transplant recipients treated with sirolimus Clin Nephrol 73 2010 344
16. J. Cohen, F. Muehlbacher US and European Sirolimus CsA Study Groups A regimen of sirolimus and reduced-dose cyclosporine results in improved renal allograft function: combined analysis of the US and European sirolimus-cyclosporine trials (Abstract) Am J Transplant 4 2004 284
17. T.S. Larson, P.G. Dean, M.D. Stegall Complete avoidance of calcineurin inhibitors in renal transplantation: a randomized trial comparing sirolimus and tacrolimus Am J Transplant 6 2006 514
18. M. Buchler, S. Caillard, S. Barbier Sirolimus versus cyclosporine in kidney recipients receiving thymoglobulin, mycophenolate mofetil and a 6-month course of steroids Am J Transplant 7 2007 2522
19. H.M. Schaefer, A.T. Kizilisik, I. Feurer Short-term results under three different immunosuppressive regimens at one center Transplant Proc 38 2006 3466
20. S.M. Flechner, M. Glyda, S. Cockfield The ORION Study: comparison of two sirolimus-based regimens versus tacrolimus and mycophenolate mofetil in renal allograft recipients Am J Transplant 11 2011 1633
21. D. Cibrik, S. Arcona, E. Vasquez Long term experience with everolimus in kidney transplantation in the United States Transplant Proc 43 2011 7
22. M. Salvador, M.P. Scolari, E. Bertoni Everolimus with very low-exposure cyclosporine a in de novo kidney transplantation: a multicenter, randomized, controlled trial Transplantation 88 2009 1194
23. S. Vitko, R. Margreiter, W. Weimar RAD B201 Study Group Three-year efficacy and safety results from a study of everolimus versus mycophenolate mofetil in de novo renal transplant patients Am J Transplant 5 2005 2521
24. R.W. Johnson, H. Kreis, R. Oberbauer Sirolimus allows early cyclosporine withdrawal in renal transplantation resulting in improved renal function and lower blood pressure Transplantation 72 2001 777
25. R. Oberbauer, G. Segoloni, J.M. Campistol Early cyclosporine withdrawal from a sirolimus-based regimen results in better renal allograft survival and renal function at 48 months after transplantation Transpl Int 18 2005 22
26. J.M. Campistol, J. Eris, R. Oberbauer Sirolimus therapy after early cyclosporine withdrawal reduces the risk for cancer in adult renal transplantation J Am Soc Nephrol 17 2006 581
27. K. Budde, T. Becker, W. Arns Everolimus- based, calcineurin-inhibitor- free regimen in recipients of de-novo kidney transplants: an open-label, randomized, controlled trial Lancet 5 2011 837