Usefulness of Delayed Introduction of Tacrolimus in Kidney Transplants Using Type-III Donors After Circulatory Death
| Autor: | E. Rodrigo-Calabia, J.C. Ruiz-San-Millán, E. Miñambres-García, M. Heras-Vicario, L. Belmar-Vega, L. Ruiz-Martínez, R. Valero-San-Cecilio, M. De-Cos-Gómez, M. Serrano-Soto, R. Palomar-Fontanet |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Basiliximab Urology Delayed Graft Function Renal function chemical and pharmacologic phenomena Tacrolimus Nephrotoxicity chemistry.chemical_compound medicine Humans Acute tubular necrosis Antilymphocyte Serum Retrospective Studies Transplantation Creatinine Thymoglobulin business.industry Incidence Middle Aged medicine.disease Kidney Transplantation Tissue Donors surgical procedures operative chemistry Female Surgery business Immunosuppressive Agents medicine.drug |
| Zdroj: | Transplantation Proceedings. 51:337-340 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2018.10.022 |
| Popis: | Introduction Our study compares 2 immunosuppressive strategies to reduce tacrolimus nephrotoxicity and its risk of acute tubular necrosis: delayed introduction of tacrolimus plus thymoglobulin vs initial tacrolimus plus basiliximab on the results of kidney transplant (KT) using type-III donation after circulatory death (III-DCD). Material and methods We analyzed all the transplants performed using type-III DCD in our hospital (42 cases). They were distributed in a first stage with delayed tacrolimus (3°-4° day) + thymoglobulin and a second one with initial tacrolimus + basiliximab, with a follow-up of 6 months. The rate of delayed graft function, the evolution of renal function, and the incidence of rejection were compared. Results 28 patients received thymoglobulin with delayed tacrolimus, and 13 patients received basiliximab and tacrolimus from day 0 (1 excluded). There were no significant differences in delayed graft function (27% group 1 and 23% group 2) or in rejection (10.7% and 15.4%), respectively. Serum creatinine at day 3, 7, 14, 30, and 180 showed no statistically significant differences. The levels of tacrolimus measured at 10, 30, 90, and 180 days after transplantation were similar, except for the first month: 10.10 ± 2.3 in group 1 and 12 ± 1.7 ng/mL in group 2 (P = .007). Conclusions Delayed introduction of tacrolimus does not seem to suppose a benefit in KT using type-III DCD; therefore, the use of thymoglobulin, with its higher profile of adverse effects, seems unjustified in patients with normal immunological risk. |
| Databáze: | OpenAIRE |
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