Conversion from everolimus with low-exposure cyclosporine to everolimus with mycophenolate sodium maintenance therapy in kidney transplant recipients: a randomized, open-label multicenter study.

Abstract:

BACKGROUND:Data in kidney transplant recipients regarding elimination of calcineurin inhibitor (CNI) therapy from a de novo regimen based on low CNI exposure and an mTOR inhibitor are sparse, and restricted to CNI elimination within the first six months post-transplant. MATERIAL/METHODS:In a 12-month, randomized, multicenter, open-label study, kidney transplant patients who had received everolimus, low-exposure cyclosporine and corticosteroids from transplantation to month 12 (with proteinuria <1 g/24 h at month 12) were randomized to convert from cyclosporine to mycophenolate sodium 720 mg/day with increased everolimus exposure (6-10 ng/mL [CNI-free group], n=15) or continue unchanged (everolimus 3-8 ng/mL [CNI group], n=15). RESULTS:Median (range) baseline mGFR was 54 (21-87) mL/min and 37 (range 18-69) mL/min (p=0.053) in the CNI-free and CNI groups, respectively, compared to 56 (18-126) mL/min and 32 (12-63) mL/min at month 12 (p=0.007). The between-group difference in change in mGFR from baseline to month 12 post-conversion (the primary endpoint) was -14.4 mL/min (95% CI -29.3 to 0.6 mL/min, p=0.059 [least squares mean]). Changes in serum creatinine and estimated GFR to month 12 were significantly in favor of CNI-free patients. One CNI patient experienced biopsy-proven acute rejection. Study drug was discontinued due to adverse events in one CNI-free patient (7%) and three CNI-treated patients (20.0%). CONCLUSIONS:Elimination of CNI from a de novo regimen of everolimus with low-exposure CNI at one year post-transplant maintained efficacy and led to a non-significant but clinically relevant improvement in renal function, although patients numbers were low (n=30). Findings from this small study require confirmation in a larger controlled trial.

journal_name

Ann Transplant

authors

Albano L,Alamartine E,Toupance O,Moulin B,Merville P,Rerolle JP,Tetaz R,Moal MC,Kamar N,Legendre C,Quéré S,Di Giambattista F,Terpereau A,Dantal J

doi

10.12659/aot.882637

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

58-67

issue

1

eissn

1425-9524

issn

2329-0358

pii

882637

journal_volume

17

pub_type

杂志文章,多中心研究,随机对照试验
  • Conversion from cyclosporine-based immunosuppression to tacrolimus/mycophenolate mofetil in patients with refractory and ongoing acute renal allograft rejection.

    abstract:AIM OF THE STUDY:was to examine the influence of conversion from cyclosporine-based therapy to tacrolimus/mycophenolate mofetil (MMF) on renal graft survival in patients with refractory rejection and on the recurrence of rejection in patients converted at the time of the first episode of rejection. PATIENTS AND METHOD...

    journal_title:Annals of transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Boratyńska M,Banasik M,Patrzałek D,Klinger M

    更新日期:2006-01-01 00:00:00

  • Myocardial performance after brain death: studies in isolated hearts.

    abstract:OBJECTIVES AND METHODS:Brain death related hemodynamic instability and/or cardiac dysfunction is frequently described in the potential organ donor which may lead to exclusion of the heart from transplantation. The underlying mechanisms are controversely discussed. Therefore, in the present study, potential brain death ...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Szabó G,Hackert T,Buhmann V,Sebening C,Vahl CF,Hagl S

    更新日期:2000-01-01 00:00:00

  • Fungal infections in liver transplant patients admitted to the intensive care unit.

    abstract:BACKGROUND:Fungal infections have a significant impact on patient survival after liver transplantation, mostly caused by Candida and Aspergillus. The clinical manifestations vary, and range from colonization, active local infection, to severe invasive form. A high degree of suspicion is required for the early diagnosis...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.892132

    authors: Marzaban R,Salah M,Mukhtar AM,Dwedar RA,Abdel-Latif W,Mahmoud I

    更新日期:2014-12-22 00:00:00

  • The spectrum of colonic complications in a lung transplant population.

    abstract:BACKGROUND:Abdominal complications are recognized as a common complication of solid organ transplantation. These complications can range from gastritis with minor morbidity to viscus perforation and death. This study addresses specifically colonic complications in lung transplant patients to highlight their high incide...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Maurer JR

    更新日期:2000-01-01 00:00:00

  • Detection of transplant renal artery stenosis in the early postoperative period with analysis of parenchymal perfusion with ultrasound contrast agent.

    abstract:BACKGROUND:Transplant renal artery stenosis (TRAS) is a serious vascular complication due to non-specific clinical manifestations, causing serious diagnostic difficulties. Contrast-enhanced ultrasound (CE-US) can complement standard sonographic examination in evaluation of TRAS. MATERIAL AND METHODS:Standard ultrasoun...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.883896

    authors: Grzelak P,Kurnatowska I,Nowicki M,Muras K,Podgórski M,Strzelczyk J,Stefańczyk L

    更新日期:2013-04-26 00:00:00

  • The APACHE III score as preoperative indicator of patient outcome in liver transplantation after fulminant hepatic failure.

    abstract:BACKGROUND:Given the current organ shortage, an accurate assessment of the patient's outcome after orthotopic liver transplantation (OLTX) for fulminant hepatic failure (FHF) is crucial in order to determine the suitability for transplantation. The purpose of this study was to assess whether APACHE II and III scores wo...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Fikatas P,Ulrich F,Lee JE,Sauer IM,Chopra S,Schmidt SC,Pascher A,Pratschke J

    更新日期:2011-01-01 00:00:00

  • Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria for the Allocation of Dual Kidneys in Adults.

    abstract::BACKGROUND Dual kidney transplantation (DKT) of expanded-criteria donors is a cost-intensive procedure that aims to increase the pool of available deceased organ donors and has demonstrated equivalent outcomes to expanded-criteria single kidney transplantation (eSKT). The objective of this study was to develop an allo...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/aot.898328

    authors: Johnson AP,Price TP,Lieby B,Doria C

    更新日期:2016-09-08 00:00:00

  • Toxic tacrolimus blood levels with rifampin administration in a renal transplant recipient.

    abstract:BACKGROUND:Induction of the hepatic and intestinal cytochrome P450-3A4 system and intestinal P-glycoprotein is an unavoidable consequence of rifampin administration which requires substantial increase in tacrolimus dose when given concurrently. Chronic diarrhea is known to precipitate tacrolimus toxicity irrespective o...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Abdel Halim M,Al-Otaibi T,Gheith O,El-Kholy O,Abdel Tawab K,Said T,Nair P,Nampoory MR

    更新日期:2010-01-01 00:00:00

  • Normothermic Machine Perfusion Protects Against Liver Ischemia-Reperfusion Injury During Reduced-Size Liver Transplantation in Pigs.

    abstract::BACKGROUND Normothermic machine perfusion (NMP) preservation is superior to cold preservation during reduced-size liver transplantation (RSLT) in pigs. However, the mechanism of this protective effect has not been explained. We aimed to compare the effects of NMP preservation with that of cold preservation (CS) in pro...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.910774

    authors: Zhang ZB,Gao W,Liu L,Shi Y,Ma N,Huai MS,Shen ZY

    更新日期:2019-01-04 00:00:00

  • Long term medical and economical benefit of machine perfusion (MP) kidney storage in comparison to cold storage (CS).

    abstract:BACKGROUND:Despite documented positive effect of MachinePerfusion (MP) on long-term kidneys-graft function its wide use is restricted due to higher costs. The aim of this study was to analyze the difference in costs of kidney transplantation in patients who received organ stored in ColdStorage (CS) vs those who receive...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Wszola M,Kwiatkowski A,Latek M,Ostrowski K,Domagala P,Ciszek M,Trzebicki J,Durlik M,Chmura A,Rowinski W

    更新日期:2009-04-01 00:00:00

  • Reactive oxygen species and molecular biology of ischemia/reperfusion.

    abstract::Ischemic reperfusion injury is a complex pathophysiological event associated with significant impairment of multiple vascular and cellular responses. Oxidative damage due to the presence of radical oxygen species is the essential step that initiates a wide range of intracellular stress signaling processes that culmina...

    journal_title:Annals of transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Toledo-Pereyra LH,Lopez-Neblina F,Toledo AH

    更新日期:2004-01-01 00:00:00

  • Liver transplantation versus supraselective transarterial chemoembolization in palliative patients with hepatocellular carcinoma exceeding the Milan Criteria - is it time for a more individual approach?

    abstract:BACKGROUND:This study evaluated the effect of liver transplantation (LTX) and STACE on overall survival in palliative patients with HCC exceeding Milan criteria. MATERIAL AND METHODS:At a single center 63 HCC patients exceeding Milan criteria were retrospectively analyzed. Forty patients underwent STACE as palliative ...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.884018

    authors: Heinzow HS,Brockmann JG,Köhler M,Wolters HH,Senninger N,Schmidt H,Meister T

    更新日期:2013-10-01 00:00:00

  • Chronic renal failure in non-renal organ transplant recipients.

    abstract::Recovery of the patients after transplantation of non-renal organs may be complicated by multi-faceted chronic renal failure (CKD) which is regarded as an independent risk factor of graft dysfunction and mortality. The occurrence of CKD in non-renal transplant recipients depends mainly on a type of transplanted organ,...

    journal_title:Annals of transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Nowicki M,Zwiech R

    更新日期:2005-01-01 00:00:00

  • The culture of temporary tumor-like bone marrow mesenchymal stem cells (TT-BMSC) and the detection of cell biology property.

    abstract:BACKGROUND:Bone marrow mesenchymal stem cells (BMSC) are common seed cells for transplantation. However, there are some limitations in their use that have not yet been resolved. Our research modified tumor-related genes temporarily on BMSC which simulated tumorigenesis temporarily in vitro. The cells were named tempora...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/aot.881995

    authors: Chen Y,Cong L,Yin X,Dong B,Han Y,Tu G

    更新日期:2011-07-01 00:00:00

  • A novel ex-vivo porcine renal xenotransplantation model using a pulsatile machine preservation system.

    abstract:BACKGROUND:Animal models to investigate pathophysiology and xenotransplantation require complex techniques and significant animal utilization. The aim of the study was to develop a reliable ex-vivo technique to test xenotransplant interventions. MATERIAL/METHODS:Miniature Swine being utilized for a nonsurvival study a...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Guarrera JV,Stone J,Tulipan J,Jhang J,Arrington B,Boykin J,Markowitz G,Ratner LE

    更新日期:2011-01-01 00:00:00

  • Causes and prognostic value of pre-transplant elevated kynurenine level in kidney allograft recipients.

    abstract:BACKGROUND:The activation of the tryptophane catabolizing enzyme Indoleamine 2,3-dioxygenase leads to the formation of kynurenine and other metabolites that counter-regulate immune activation resulting in restoration of immune homeostasis. But in chronic immune activation, as in hemodialysed patients, the immunosuppres...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.889764

    authors: Kaden J,Abendroth D,Völp A,Marzinzig M,Wesslau C

    更新日期:2014-01-27 00:00:00

  • Late onset post transplantation lymphoproliferative disorders: analysis of international data from 5 studies.

    abstract:BACKGROUND:Organ transplantation increases the risk of cancer including lymphomas through various and insidious mechanisms. In this study, we aimed to gather and analyze data of 5 international studies on late onset lymphoproliferative disorders after renal and liver transplantation. MATERIAL/METHODS:We conducted a co...

    journal_title:Annals of transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Khedmat H,Taheri S

    更新日期:2009-10-01 00:00:00

  • Transplant Nurses' Work Environment: A Cross-Sectional Multi-Center Study.

    abstract::BACKGROUND Numerically, nurses represent the largest healthcare profession, thus setting norms for the quality and safety of direct patient care. Evidence of a global shortage of nurses in all clinical practice settings across different healthcare systems and countries has been documented. The aims of the present stud...

    journal_title:Annals of transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.12659/aot.898305

    authors: Kugler C,Akca S,Einhorn I,Rebafka A,Russell CL

    更新日期:2016-09-01 00:00:00

  • Effects of Delayed Hypothermic Machine Perfusion on Kidney Grafts with a Preliminary Period of Static Cold Storage and a Total Cold Ischemia Time of Over 24 Hours.

    abstract::BACKGROUND Hypothermic machine perfusion (HMP) appears to exert a reconditioning effect on the ischemic damage of kidney grafts. However, some concerns still remain about its real effectiveness when it is delayed after a preliminary period of static cold storage (SCS) or with prolonged overall cold ischemia time (CIT)...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.918997

    authors: Adani GL,Pravisani R,Crestale S,Baccarani U,Scott CA,D'Alì L,DeMaglio G,Tulissi P,Vallone C,Isola M,Righi E,Pizzolito S,Di Loreto C,Risaliti A

    更新日期:2020-02-25 00:00:00

  • Transarterial Chemoembolization Prior to Liver Transplantation in Patients with Hepatocellular Carcinoma.

    abstract:BACKGROUND:Transarterial chemoembolization (TACE) induces ischemic tumor necrosis, which is intensified by regional chemotherapy. By reducing the active tumor tissue, it can be assumed that patients on the waiting list for liver transplantation may benefit from this locoregional treatment. The aim of this study was to ...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/aot.896778

    authors: Hołówko W,Wróblewski T,Wojtaszek M,Grąt M,Kobryń K,Ziarkiewicz-Wróblewska B,Krawczyk M

    更新日期:2015-12-29 00:00:00

  • Causes of re-hospitalization in different post kidney transplantation periods.

    abstract:BACKGROUND:Post kidney transplantation Re-admissions are focused because they are costly and cause morbidity, or may end with unsatisfactory endpoints namely graft loss or death. We compared the pattern, outcome and cost of re-admissions in different post-kidney transplantation periods. MATERIAL/METHODS:In a retrospec...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Moghani Lankarani M,Noorbala MH,Assari S

    更新日期:2009-10-01 00:00:00

  • Preoperative Echocardiography Examination of Right Ventricle Function in Patients Scheduled for LVAD Implantation Correlates with Postoperative Hemodynamic Examinations.

    abstract::BACKGROUND Left ventricular assist devices (LVAD) are used to treat heart failure. Preoperative prediction of RV function after LVAD implantation is crucial. Correlations were found between preoperative echo and RV function after LVAD implantation. MATERIAL AND METHODS We retrospectively reviewed 23 male patients (8 i...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/aot.899054

    authors: Nadziakiewicz P,Niklewski T,Szyguła-Jurkiewicz B,Pacholewicz J,Zakliczyński M,Borkowski J,Hrapkowicz T,Zembala M

    更新日期:2016-08-11 00:00:00

  • Successful full-term pregnancy in a patient three and a half years after a heart transplant.

    abstract::The patient is a 28 year old woman who received a heart transplant in 1992 secondary to hypertrophic cardiomyopathy with unremarkable post-operative course. In the period immediately post transplantation the patient was on a four-drug immunosuppressive regimen which was subsequently changed to standard three-agent the...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Dziatkowiak A,Zdebski Z,Tracz W,Piwowarska W,Garlicki M,Kapelak B,Tomaszczyk T,Migdał M,Wysocka T,Sadowski J,Pfitzner R,Nessler J,Pietrzyk E,Wójcik S,Rudziński P,Lesniak A

    更新日期:1996-01-01 00:00:00

  • Activity of glutathione S-transferases in the urine of kidney transplant recipients during the first week after transplantation.

    abstract:UNLABELLED:Glutathione S-Tranferases (GST) are the enzymes which are strictly specific for epithelial cells of the proximal and distal tubules in the kidney. These enzymes are detected in the urine when some tubular damage process is found. In healthy people urine GST is hardly detected. The goal of this study was to e...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Polak WP,Kosieradzki M,Kwiatkowski A,Danielewicz R,Lisik W,Michalak G,Paczek L,Lao M,Wałaszewski J,Rowiński WA

    更新日期:1999-01-01 00:00:00

  • Living Donor Liver Transplantation in Acute Liver Failure Patients with Grade IV Encephalopathy: Is Deep Hepatic Coma Still an Absolute Contraindication? A Successful Single-Center Experience.

    abstract::BACKGROUND The prognosis of the patients of acute liver failure (ALF) with onset of hepatic coma is often dismal. ALF is a well-accepted indication for liver transplantation (LT) and has markedly improved the prognosis of these patients. However, its role in ALF patients with onset of hepatic coma has never been eluci...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Yang HR,Thorat A,Jeng LB,Hsu SC,Li PC,Yeh CC,Chen TH,Poon KS

    更新日期:2018-03-13 00:00:00

  • Postoperative assessment of hepatic asialoglycoprotein receptor function with Tc-99m GSA: the safety margin of resection size in living donor liver transplantation.

    abstract:BACKGROUND:Living liver donation is associated with size-dependent complications. The resectable size and its safety margin should be defined for the safety of donors. The purpose of the present study was to determine if the current partial hepatectomies are done under the safety margin of the resectable size, by measu...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.892490

    authors: Kobayashi K,Hattori N,Manabe O,Hirata K,Magota K,Shimamura T,Tamaki N

    更新日期:2015-01-26 00:00:00

  • The effect of The World Transplant Games on transplant rates in five continents.

    abstract::This paper outlines the effect that the Transplant Games have had in influencing public opinion and the translation of that effect resulting in increased organ donation and transplantation in the global venues in which this activity took place. A brief account of the history of the Transplant Games now 25 years after ...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Slapak M

    更新日期:2004-01-01 00:00:00

  • The Czech Bone Marrow Donor Registry.

    abstract:OBJECTIVE:The Czech Bone Marrow Donor Registry (CBMD)--established 9 years ago, operates within the National HLA Centre, a constituent part of the Department of Immunology at the Institute for Clinical and Experimental Medicine. The Czech Cord Blood Register (CSCB) was recently established (in 1996) and started its act...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:

    authors: Kupková L,Bendukidze N,Slavcev A,Ivasková E

    更新日期:2001-01-01 00:00:00

  • ABO-Incompatible Living Donor Liver Transplantation with Reduced Rituximab Dose: A Retrospective Analysis of 65 Patients - Can We Fast-Track Liver Transplant Surgery and Improve Long-Term Survival?

    abstract::BACKGROUND ABO-incompatible (ABO-i) living donor liver transplantation (LDLT) is a feasible alternative for donor liver allograft in emergency situations, especially in Asia, where deceased-donor organs remain scarce. The reported outcomes of ABO-i LDLT after optimal desensitization are comparable to those of ABO-comp...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/AOT.923502

    authors: Hsu SC,Thorat A,Jeng LB,Li PC,Chen TH,Yang HR,Poon KS

    更新日期:2020-09-18 00:00:00

  • Does Immunosuppressive Therapy Affect Markers of Kidney Damage?

    abstract:BACKGROUND:Markers currently used to detect kidney damage are effective in both early (KIM-1, NGAL) and late (MCP-1, MMP, TIMP) stages of renal tubular damage, indicating the progression of chronic kidney disease. Immunosuppressive drugs may damage the transplanted organ through their direct toxic effects and by contri...

    journal_title:Annals of transplantation

    pub_type: 杂志文章

    doi:10.12659/aot.895275

    authors: Kędzierska K,Sindrewicz K,Sporniak-Tutak K,Gołembiewska E,Zair L,Sieńko J,Stańczyk-Dunaj M,Baranowska-Bosiacka I,Ciechanowski K

    更新日期:2016-03-03 00:00:00