Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus
It is not known how different steroid-free immunosuppressive combinations affect long-term kidney transplant function in recipients of simultaneous kidney and pancreas transplant (SPK). Here, we sought to evaluate, in SPK recipients, the impact on long-term renal allograft function of two Tac-based...
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| Veröffentlicht in: | Transplantation 2007-05, Vol.83 (10), p.1324-1329 |
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| creator | GALLON, Lorenzo G WINOTO, Johan CHHABRA, Darshika PARKER, Michele A LEVENTHAL, Joseph R KAUFMAN, Dixon B |
| description | It is not known how different steroid-free immunosuppressive combinations affect long-term kidney transplant function in recipients of simultaneous kidney and pancreas transplant (SPK). Here, we sought to evaluate, in SPK recipients, the impact on long-term renal allograft function of two Tac-based prednisone-free maintenance immunosuppressive protocols: tacrolimus (Tac)/mycophonelate mofetil (MMF) versus Tac/ sirolimus (SRL).
In this single-center, retrospective, sequential study, we analyzed 59 SPK transplant patients with at median follow up of 5 years. All patients received induction therapy with thymoglobulin and maintenance immunosuppression with Tac/MMF (n=22) or Tac/SRL (n=37). There were no differences between the two groups in regards to age, gender, race, panel reactive antibodies, degree of mismatch, donor age, incidence of delay graft function, and Tac trough levels at different time points after transplantation.
Kaplan-Meier patient survival at 6 years after transplantation was not statistically different between the two groups. Rate of ACR was similar. Kidney survival, even if not statistically significant, was better in the Tac/MMF group than in the Tac/SRL (90.7% vs. 70.7%, P=0.09). The slope of glomerular filtration rate decline per month at 5 years after transplantation was not statistically different between the two groups. Both groups had the same decline over time in glomerular filtration rate of 0.40+/-0.06 mL/min/1.73/month. Pancreas survival at 6 years after transplantation was 100% in both treatment groups.
Our data suggest that, in SPK recipients, long-term kidney allograft survival and function are not statistically different. A trend toward an increased rate of renal allograft loss was found in the Tac/SRL-treated group. |
| doi_str_mv | 10.1097/01.tp.0000264189.58324.91 |
| format | Article |
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In this single-center, retrospective, sequential study, we analyzed 59 SPK transplant patients with at median follow up of 5 years. All patients received induction therapy with thymoglobulin and maintenance immunosuppression with Tac/MMF (n=22) or Tac/SRL (n=37). There were no differences between the two groups in regards to age, gender, race, panel reactive antibodies, degree of mismatch, donor age, incidence of delay graft function, and Tac trough levels at different time points after transplantation.
Kaplan-Meier patient survival at 6 years after transplantation was not statistically different between the two groups. Rate of ACR was similar. Kidney survival, even if not statistically significant, was better in the Tac/MMF group than in the Tac/SRL (90.7% vs. 70.7%, P=0.09). The slope of glomerular filtration rate decline per month at 5 years after transplantation was not statistically different between the two groups. Both groups had the same decline over time in glomerular filtration rate of 0.40+/-0.06 mL/min/1.73/month. Pancreas survival at 6 years after transplantation was 100% in both treatment groups.
Our data suggest that, in SPK recipients, long-term kidney allograft survival and function are not statistically different. A trend toward an increased rate of renal allograft loss was found in the Tac/SRL-treated group.</description><identifier>ISSN: 0041-1337</identifier><identifier>EISSN: 1534-6080</identifier><identifier>DOI: 10.1097/01.tp.0000264189.58324.91</identifier><identifier>PMID: 17519781</identifier><identifier>CODEN: TRPLAU</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiviral agents ; Biological and medical sciences ; Cohort Studies ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Rejection - epidemiology ; Graft Survival ; Humans ; Immunosuppressive Agents - therapeutic use ; Kidney Transplantation - immunology ; Kidney Transplantation - mortality ; Kidney Transplantation - physiology ; Male ; Medical sciences ; Middle Aged ; Mycophenolic Acid - analogs & derivatives ; Mycophenolic Acid - therapeutic use ; Pancreas Transplantation - immunology ; Pancreas Transplantation - mortality ; Pancreas Transplantation - physiology ; Pharmacology. Drug treatments ; Retrospective Studies ; Sirolimus - therapeutic use ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Survival Analysis ; Tacrolimus - therapeutic use ; Time Factors ; Tissue, organ and graft immunology ; Treatment Outcome</subject><ispartof>Transplantation, 2007-05, Vol.83 (10), p.1324-1329</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c458t-7e16be6f536b24999a4fd32c2a1be8561840756d8df3334ab45658ece62e635a3</citedby><cites>FETCH-LOGICAL-c458t-7e16be6f536b24999a4fd32c2a1be8561840756d8df3334ab45658ece62e635a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18798028$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17519781$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GALLON, Lorenzo G</creatorcontrib><creatorcontrib>WINOTO, Johan</creatorcontrib><creatorcontrib>CHHABRA, Darshika</creatorcontrib><creatorcontrib>PARKER, Michele A</creatorcontrib><creatorcontrib>LEVENTHAL, Joseph R</creatorcontrib><creatorcontrib>KAUFMAN, Dixon B</creatorcontrib><title>Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus</title><title>Transplantation</title><addtitle>Transplantation</addtitle><description>It is not known how different steroid-free immunosuppressive combinations affect long-term kidney transplant function in recipients of simultaneous kidney and pancreas transplant (SPK). Here, we sought to evaluate, in SPK recipients, the impact on long-term renal allograft function of two Tac-based prednisone-free maintenance immunosuppressive protocols: tacrolimus (Tac)/mycophonelate mofetil (MMF) versus Tac/ sirolimus (SRL).
In this single-center, retrospective, sequential study, we analyzed 59 SPK transplant patients with at median follow up of 5 years. All patients received induction therapy with thymoglobulin and maintenance immunosuppression with Tac/MMF (n=22) or Tac/SRL (n=37). There were no differences between the two groups in regards to age, gender, race, panel reactive antibodies, degree of mismatch, donor age, incidence of delay graft function, and Tac trough levels at different time points after transplantation.
Kaplan-Meier patient survival at 6 years after transplantation was not statistically different between the two groups. Rate of ACR was similar. Kidney survival, even if not statistically significant, was better in the Tac/MMF group than in the Tac/SRL (90.7% vs. 70.7%, P=0.09). The slope of glomerular filtration rate decline per month at 5 years after transplantation was not statistically different between the two groups. Both groups had the same decline over time in glomerular filtration rate of 0.40+/-0.06 mL/min/1.73/month. Pancreas survival at 6 years after transplantation was 100% in both treatment groups.
Our data suggest that, in SPK recipients, long-term kidney allograft survival and function are not statistically different. A trend toward an increased rate of renal allograft loss was found in the Tac/SRL-treated group.</description><subject>Adult</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Kidney Transplantation - immunology</subject><subject>Kidney Transplantation - mortality</subject><subject>Kidney Transplantation - physiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mycophenolic Acid - analogs & derivatives</subject><subject>Mycophenolic Acid - therapeutic use</subject><subject>Pancreas Transplantation - immunology</subject><subject>Pancreas Transplantation - mortality</subject><subject>Pancreas Transplantation - physiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Retrospective Studies</subject><subject>Sirolimus - therapeutic use</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Survival Analysis</subject><subject>Tacrolimus - therapeutic use</subject><subject>Time Factors</subject><subject>Tissue, organ and graft immunology</subject><subject>Treatment Outcome</subject><issn>0041-1337</issn><issn>1534-6080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFks-O1SAYxRujce6MvoLBhe7agfLfnZnoaHITN-O6ofSrg7ZQgc7kvrMPIdfb5LobEgKBH-c7wKmqtwQ3BGt5jUmTlwaX1gpGlG64oi1rNHlW7QinrBZY4efVDmNGakKpvKguU_pZeE6lfFldEMmJlorsqj_74H_UGeKMIngzoRyNT8tkfEbj6m12wSPny6Z1i4OyGkaU3LxO2XgIa0K_3ODhgIwf0GK8jWDS_yKzcT6XDgN6dPke5ceAlgiDdyl4qMcIcGJKdW8BuXlefUjrUqCU3AMgG-beeXN0kj6gO2NjmIqBdD0fbFjuwYfJ5CISRshuQg8QU7GVz1xy2-xV9WI0U4LX23hVff_86e7mS73_dvv15uO-toyrXEsgogcxcir6lmmtDRsH2trWkB4UF0QxLLkY1DBSSpnpGRdcgQXRgqDc0Kvq_Ul3ieH3Cil3s0sWpun0ZJ3EvGUKkyfBFgshJdNPgkQLTSVrC6hPYLl9ShHGboluNvHQEdwdw9Nh0uWlO4en-xeeTh_dvNmKrP0Mw_nklpYCvNsAk6yZxvLL1qUzp6RWuFX0L3KE12s</recordid><startdate>20070527</startdate><enddate>20070527</enddate><creator>GALLON, Lorenzo G</creator><creator>WINOTO, Johan</creator><creator>CHHABRA, Darshika</creator><creator>PARKER, Michele A</creator><creator>LEVENTHAL, Joseph R</creator><creator>KAUFMAN, Dixon B</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20070527</creationdate><title>Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus</title><author>GALLON, Lorenzo G ; WINOTO, Johan ; CHHABRA, Darshika ; PARKER, Michele A ; LEVENTHAL, Joseph R ; KAUFMAN, Dixon B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c458t-7e16be6f536b24999a4fd32c2a1be8561840756d8df3334ab45658ece62e635a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Kidney Transplantation - immunology</topic><topic>Kidney Transplantation - mortality</topic><topic>Kidney Transplantation - physiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mycophenolic Acid - analogs & derivatives</topic><topic>Mycophenolic Acid - therapeutic use</topic><topic>Pancreas Transplantation - immunology</topic><topic>Pancreas Transplantation - mortality</topic><topic>Pancreas Transplantation - physiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Retrospective Studies</topic><topic>Sirolimus - therapeutic use</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Survival Analysis</topic><topic>Tacrolimus - therapeutic use</topic><topic>Time Factors</topic><topic>Tissue, organ and graft immunology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GALLON, Lorenzo G</creatorcontrib><creatorcontrib>WINOTO, Johan</creatorcontrib><creatorcontrib>CHHABRA, Darshika</creatorcontrib><creatorcontrib>PARKER, Michele A</creatorcontrib><creatorcontrib>LEVENTHAL, Joseph R</creatorcontrib><creatorcontrib>KAUFMAN, Dixon B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GALLON, Lorenzo G</au><au>WINOTO, Johan</au><au>CHHABRA, Darshika</au><au>PARKER, Michele A</au><au>LEVENTHAL, Joseph R</au><au>KAUFMAN, Dixon B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus</atitle><jtitle>Transplantation</jtitle><addtitle>Transplantation</addtitle><date>2007-05-27</date><risdate>2007</risdate><volume>83</volume><issue>10</issue><spage>1324</spage><epage>1329</epage><pages>1324-1329</pages><issn>0041-1337</issn><eissn>1534-6080</eissn><coden>TRPLAU</coden><abstract>It is not known how different steroid-free immunosuppressive combinations affect long-term kidney transplant function in recipients of simultaneous kidney and pancreas transplant (SPK). Here, we sought to evaluate, in SPK recipients, the impact on long-term renal allograft function of two Tac-based prednisone-free maintenance immunosuppressive protocols: tacrolimus (Tac)/mycophonelate mofetil (MMF) versus Tac/ sirolimus (SRL).
In this single-center, retrospective, sequential study, we analyzed 59 SPK transplant patients with at median follow up of 5 years. All patients received induction therapy with thymoglobulin and maintenance immunosuppression with Tac/MMF (n=22) or Tac/SRL (n=37). There were no differences between the two groups in regards to age, gender, race, panel reactive antibodies, degree of mismatch, donor age, incidence of delay graft function, and Tac trough levels at different time points after transplantation.
Kaplan-Meier patient survival at 6 years after transplantation was not statistically different between the two groups. Rate of ACR was similar. Kidney survival, even if not statistically significant, was better in the Tac/MMF group than in the Tac/SRL (90.7% vs. 70.7%, P=0.09). The slope of glomerular filtration rate decline per month at 5 years after transplantation was not statistically different between the two groups. Both groups had the same decline over time in glomerular filtration rate of 0.40+/-0.06 mL/min/1.73/month. Pancreas survival at 6 years after transplantation was 100% in both treatment groups.
Our data suggest that, in SPK recipients, long-term kidney allograft survival and function are not statistically different. A trend toward an increased rate of renal allograft loss was found in the Tac/SRL-treated group.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>17519781</pmid><doi>10.1097/01.tp.0000264189.58324.91</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Biological and medical sciences Cohort Studies Drug Therapy, Combination Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Rejection - epidemiology Graft Survival Humans Immunosuppressive Agents - therapeutic use Kidney Transplantation - immunology Kidney Transplantation - mortality Kidney Transplantation - physiology Male Medical sciences Middle Aged Mycophenolic Acid - analogs & derivatives Mycophenolic Acid - therapeutic use Pancreas Transplantation - immunology Pancreas Transplantation - mortality Pancreas Transplantation - physiology Pharmacology. Drug treatments Retrospective Studies Sirolimus - therapeutic use Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Survival Analysis Tacrolimus - therapeutic use Time Factors Tissue, organ and graft immunology Treatment Outcome |
| title | Long-term renal transplant function in recipient of simultaneous kidney and pancreas transplant maintained with two prednisone-free maintenance immunosuppressive combinations: Tacrolimus/mycophenolate mofetil versus tacrolimus/sirolimus |
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