| Autor: |
Thierry, Antoine, Lemeur, Yann, Ecotière, Laure, Abou-Ayache, Ramzi, Etienne, Isabelle, Laurent, Charlotte, Vuiblet, Vincent, Colosio, Charlotte, Bouvier, Nicolas, Aldigier, Jean-Claude, Rerolle, Jean-Philippe, Javaugue, Vincent, Gand, Elise, Bridoux, Frank, Essig, Marie, Hurault de Ligny, Bruno, Touchard, Guy |
| Předmět: |
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| Zdroj: |
Transplant International; Jan2016, Vol. 29 Issue 1, p23-33, 11p |
| Abstrakt: |
Long-term outcomes in renal transplant recipients withdrawn from steroid and submitted to further minimization of immunosuppressive regimen after 1 year are lacking. In this multicenter study, 204 low immunological risk kidney transplant recipients were randomized 14.2 ± 3.7 months post-transplantation to receive either cyclosporine A (CsA) + azathioprine ( AZA; n = 53), CsA + mycophenolate mofetil ( MMF; n = 53), or CsA monotherapy ( n = 98). At 3 years postrandomization, the occurrence of biopsy for graft dysfunction was similar in bitherapy and monotherapy groups (21/106 vs. 26/98; P = 0.25). At 10 years postrandomization, patients' survival was 100%, 94.2%, and 95.8% ( P = 0.25), and death-censored graft survival was 94.9%, 94.7%, and 95.2% ( P = 0.34) in AZA, MMF, and CsA groups, respectively. Mean estimated glomerular filtration rate was 70.4 ± 31.1, 60.1 ± 22.2, and 60.1 ± 19.0 ml/min/1.73 m2, respectively ( P = 0.16). The incidence of biopsy-proven acute rejection was 1.4%/year in the whole cohort. None of the patients developed polyomavirus-associated nephropathy. The main cause of graft loss ( n = 12) was chronic antibody-mediated rejection ( n = 6). De novo donor-specific antibodies were detected in 13% of AZA-, 21% of MMF-, and 14% of CsA-treated patients ( P = 0.29). CsA monotherapy after 1 year is safe and associated with prolonged graft survival in well-selected renal transplant recipient ( number: 980654). [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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