The effect of mycophenolate mofetil and azathioprine dose on renal allograft outcome in the United kingdom.

Abstract:

BACKGROUND:Mycophenolate mofetil (MMF) therapy compared with azathioprine has not led to improved long-term renal allograft outcomes perhaps as MMF dose is limited by tolerability and dose reduction is associated with inferior graft outcome. The consequences, however, of dose reduction of mycophenolate mofetil relative to azathioprine have not been reported. METHOD:We studied dosing patterns of MMF and azathioprine in the first year after transplantation and their impact on graft outcome after renal transplantation between 1999 and 2002 in the United Kingdom. RESULTS:Sixty-two percent of patients were found to be taking less than 2 g of MMF and 45% were taking less than 100 mg of azathioprine at 1 year after transplantation. Graft outcome was comparable in patients receiving 2 g or more of MMF (n=209), 1 to 2 g of MMF (n=267), and 100 mg or more of azathioprine (n=504) at 1 year after transplantation. Less than 1 g of MMF (n=71) and less than 100 mg of azathioprine (n=413) was associated with a 3-fold and 2-fold increased 4.5 year risk-adjusted hazard ratio (HR) of graft failure, respectively, with reduced graft function. Finally, less than 1 g of MMF was not superior to less than 100 mg of azathioprine. CONCLUSION:Azathioprine levels are not routinely measured and long-term results of concentration controlled MMF studies are awaited. Currently, dose is a useful measure of drug exposure. This study suggests that less than 1 g of MMF and less than 100 mg of azathioprine are associated with inferior graft outcome.

journal_name

Transplantation

journal_title

Transplantation

authors

Shah S,Collett D,Johnson R,Raftery M,Rudge C,Yaqoob MM

doi

10.1097/TP.0b013e318186dc81

subject

Has Abstract

pub_date

2008-10-27 00:00:00

pages

1035-42

issue

8

eissn

0041-1337

issn

1534-6080

pii

00007890-200810270-00005

journal_volume

86

pub_type

杂志文章
  • Update on C1 Esterase Inhibitor in Human Solid Organ Transplantation.

    abstract::Complement plays important roles in both ischemia-reperfusion injury (IRI) and antibody-mediated rejection (AMR) of solid organ allografts. One approach to possibly improve outcomes after transplantation is the use of C1 inhibitor (C1-INH), which blocks the first step in both the classical and lectin pathways of compl...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000002717

    authors: Berger M,Lefaucheur C,Jordan SC

    更新日期:2019-09-01 00:00:00

  • Cold ischemia and outcome in 17,937 cadaveric kidney transplants.

    abstract::To determine if cold preservation time continues to affect renal transplant outcome, prospectively collected data from 17,937 cadaveric renal transplants performed between 1982 and 1991 were analyzed. Cold preservation intervals of 1-16, 16-32, 32-48, and greater than 48 hr were studied by multi- and univariate method...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:

    authors: Peters TG,Shaver TR,Ames JE 4th,Santiago-Delpin EA,Jones KW,Blanton JW

    更新日期:1995-01-27 00:00:00

  • Histological study of urinary bladder transplantation in rats.

    abstract::Patients who require cystectomy are usually treated with an ileal conduit or intestinal neobladder for urinary control. In some of them, however, the bowel segment cannot be used because of previous abdominal surgery or radiation treatment. Bladder transplantation from cadavers may be beneficial to these patients, if ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199704150-00002

    authors: Takeuchi K,Takechi S,Ohoka H,Yokoyama M,Iwata H,Takeuchi M,Matsuda S

    更新日期:1997-04-15 00:00:00

  • The lymphatic drainage of the rat prostate and its status as an immunologically privileged site.

    abstract::Recent suggestions that the rat prostate is an alymphatic, immunologically privileged site stimulated further investigation of its status using a variety of techniques. Fixation of certain organs by vascular perfusion of glutaraldehyde followed by plastic embedding avoids the distortion and stromal reorganization that...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197902000-00011

    authors: Neaves WB,Billingham RE

    更新日期:1979-02-01 00:00:00

  • Improved metabolic control and quality of life in seven patients with type 1 diabetes following islet after kidney transplantation.

    abstract:BACKGROUND:The beneficial effects of glycemic control on both survival and function of transplanted kidneys in patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease (ESRD) have been recognized. METHODS:Herein, we present the clinical outcome of a single-center pilot trial of islet after kidney (IAK...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e318166a27b

    authors: Cure P,Pileggi A,Froud T,Messinger S,Faradji RN,Baidal DA,Cardani R,Curry A,Poggioli R,Pugliese A,Betancourt A,Esquenazi V,Ciancio G,Selvaggi G,Burke GW 3rd,Ricordi C,Alejandro R

    更新日期:2008-03-27 00:00:00

  • In vivo alloreactive potential of ex vivo-expanded primary T lymphocytes.

    abstract:BACKGROUND:We are presently investigating the therapeutic potential of herpes simplex-thymidine kinase-expressing donor T cells in the setting of a T cell-depleted allogeneic bone marrow transplantation. The generation, expansion, and selection of the gene-modified T cells require a 12-day ex vivo culture period in hig...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199805270-00014

    authors: Contassot E,Murphy W,Angonin R,Pavy JJ,Bittencourt MC,Robinet E,Reynolds CW,Cahn JY,Hervé P,Tiberghien P

    更新日期:1998-05-27 00:00:00

  • Human granulocytic ehrlichiosis in a renal transplant patient: case report and review of the literature.

    abstract:BACKGROUND:Human ehrlichiosis, a newly described zoonotic infection, can be classified as human monocytic ehrlichiosis (HME) or human granulocytic ehrlichiosis (HGE). Although the clinical manifestations of HME and HGE are similar, the type of leukocyte infected, the etiologic agent, and the tick vector are distinct. ...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/00007890-199710270-00010

    authors: Adachi JA,Grimm EM,Johnson P,Uthman M,Kaplan B,Rakita RM

    更新日期:1997-10-27 00:00:00

  • Renal allograft survival in patients with oxalosis.

    abstract:BACKGROUND:Primary hyperoxaluria is a rare autosomal recessive metabolic disease that often progresses to end-stage renal disease (ESRD). Liver transplantation is curative for patients with the alanine: glyoxylate aminotransferase deficiency. For oxalosis patients with minor enzyme deficiencies, renal transplantation m...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00007890-200209150-00020

    authors: Cibrik DM,Kaplan B,Arndorfer JA,Meier-Kriesche HU

    更新日期:2002-09-15 00:00:00

  • Contrasted blood and intragraft toll-like receptor 4 mRNA profiles in operational tolerance versus chronic rejection in kidney transplant recipients.

    abstract:BACKGROUND:Deciphering the mechanisms of tolerance and chronic rejection (CR) remains a major goal in transplantation. Data in rodents suggest that Toll-like receptors (TLR), regulators of innate immune responses, play a role in determining graft outcome. However, few studies have focused on TLR expression in human kid...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31817b8dc5

    authors: Braudeau C,Ashton-Chess J,Giral M,Dugast E,Louis S,Pallier A,Braud C,Moreau A,Renaudin K,Soulillou JP,Brouard S

    更新日期:2008-07-15 00:00:00

  • Optical determination of fatty change of the graft liver with near-infrared time-resolved spectroscopy.

    abstract::A novel method for quantifying the fatty change of the graft liver by characterizing the optical property of the tissue was introduced. A wide range of lipid content in the rat liver was obtained by using different feeding regimens, with lipotropic chow (choline/methionine deficient or low chow). The liver was removed...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199609150-00018

    authors: Kitai T,Beauvoit B,Chance B

    更新日期:1996-09-15 00:00:00

  • Over 500 solitary pancreas transplants in nonuremic patients with brittle diabetes mellitus.

    abstract:BACKGROUND:A pancreas transplant alone (PTA) in a nonuremic patient with brittle diabetes mellitus remains a rare procedure because the tradeoff for insulin independence is lifelong immunosuppression. METHODS:Herein we report our results at the University of Minnesota of 513 PTAs from December 17, 1966, through Decemb...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000296820.46978.3f

    authors: Gruessner RW,Sutherland DE,Kandaswamy R,Gruessner AC

    更新日期:2008-01-15 00:00:00

  • Characteristics of dendritic cells in rat liver.

    abstract::The properties of rat liver dendritic cells (DC) were analyzed after collagenase digestion of the tissue and enrichment with density gradient centrifugation. The liver macrophages (Kupffer cells) were eliminated by adherence before the gradient centrifugation. The morphology of isolated DC in May-Grunwald-Giemsa (MGG)...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198805000-00019

    authors: Lautenschlager I,Halttunen J,Häyry P

    更新日期:1988-05-01 00:00:00

  • Effects of steroid hormones on phytohemagglutinin-stimulated human peripheral blood lymphocytes.

    abstract::The interactions of steroid hormones and human peripheral blood lymphocytes (PBLs) have been investigated following glass-wool column separation of PBLs and incubation in a serum-free medium in the presence of phytohemagglutinin (PHA). Addition of hydrocortisone or progesterone above physiological concentrations resul...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197905000-00004

    authors: Neifeld JP,Tormey DC

    更新日期:1979-05-01 00:00:00

  • Risk-stratified screening for ischemic heart disease in kidney transplant candidates.

    abstract:BACKGROUND:Few studies have examined the effectiveness of a risk-stratified approach to screening kidney transplantation candidates for ischemic heart disease (IHD). METHODS:We retrospectively reviewed records from all adult patients (n = 514) placed on the deceased donor kidney transplantation waiting list at a singl...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000173652.87417.ca

    authors: Kasiske BL,Malik MA,Herzog CA

    更新日期:2005-09-27 00:00:00

  • Financial incentives for cadaver organ donation: an ethical reappraisal.

    abstract::A panel of ethicists, organ procurement organization executives, physicians, and surgeons was convened by the sponsorship of the American Society of Transplant Surgeons to determine whether an ethically acceptable pilot trial could be proposed to provide a financial incentive for a family to consent to the donation of...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200204270-00034

    authors: Arnold R,Bartlett S,Bernat J,Colonna J,Dafoe D,Dubler N,Gruber S,Kahn J,Luskin R,Nathan H,Orloff S,Prottas J,Shapiro R,Ricordi C,Youngner S,Delmonico FL

    更新日期:2002-04-27 00:00:00

  • Phenotypic composition and in vitro functional capacities of unmodified fresh cells infiltrating acutely rejected human kidney allografts.

    abstract::Cell surface markers of isolated graft-infiltrating cells (GIC) were studied, and functional in vitro assays performed in 8 cases of acute irreversible rejection of human renal allografts. The GIC were mostly activated T cells (OKT11+, OKT3+, Ia+), with predominance of the cytotoxic/suppressor T cell phenotype (OKT8+)...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198707000-00010

    authors: Charpentier BM,Bach MA,Lang P,Martin B,Fries D

    更新日期:1987-07-01 00:00:00

  • Propagation of lymphocytes infiltrating human liver allografts. Correlation with histologic diagnosis of rejection.

    abstract::In this study, we have investigated whether lymphocyte growth from 196 liver transplant biopsies is correlated with the histologic diagnosis of graft rejection. One fragment of each biopsy was cultured in IL-2 to expand activated T cells, and the remainder of the biopsy was analyzed histologically. A significantly hig...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199001000-00024

    authors: Saidman SL,Demetris AJ,Zeevi A,Duquesnoy RJ

    更新日期:1990-01-01 00:00:00

  • Immunologic pathways in a quantitative model of immunosuppression based on rejection of an allogeneic or xenogeneic tumor graft.

    abstract:BACKGROUND:A quantitative model of immunosuppression was previously developed based on the rejection of the allogeneic A/J murine tumor sarcoma 1 (Sa1) in immunocompetent mice. Here, the model is used to evaluate the immunologic mechanisms of graft rejection and to determine the potential of this model to detect synerg...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000157361.50830.22

    authors: Hammond-McKibben D,Saulnier M,Zhang J,Risher N,Lake P,Weetall M

    更新日期:2005-04-27 00:00:00

  • Islet graft survival and function: concomitant culture and transplantation with vascular endothelial cells in diabetic rats.

    abstract:BACKGROUND:Human islet transplantation is a great potential therapy for type I diabetes. To investigate islet graft survival and function, we recently showed the improved effects after co-culture and co-transplantation with vascular endothelial cells (ECs) in diabetic rats. METHODS:ECs were isolated, and the viability...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3182356ca7

    authors: Pan X,Xue W,Li Y,Feng X,Tian X,Ding C

    更新日期:2011-12-15 00:00:00

  • The role of pretransplant immunity in protection from cytomegalovirus disease following renal transplantation.

    abstract::To determine the extent to which pretransplant immunity resulting from natural infection protects against cytomegalovirus (CMV) disease, we analyzed CMV serology on 153 kidney donor and recipient pairs and followed transplant patients to determine incidence and severity of CMV disease. The overall incidence of CMV dis...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198508000-00010

    authors: Smiley ML,Wlodaver CG,Grossman RA,Barker CF,Perloff LJ,Tustin NB,Starr SE,Plotkin SA,Friedman HM

    更新日期:1985-08-01 00:00:00

  • The effect of prostaglandin E1 on heart preservation.

    abstract::The purpose of this study was to investigate the effect of prostaglandin E1 on rabbit heart preservation. The hearts were arrested with cardioplegia (CP) solution, followed by intracoronary infusion of Euro-Collins (E-C) solution. They were immersed in E-C solution at 4 degrees C for 9 hr, flushed with terminal warm C...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199209000-00006

    authors: Ueno T,Horita K,Okazaki Y,Itoh T,Natsuaki M

    更新日期:1992-09-01 00:00:00

  • Lymphoma and hypercalcemia in a pediatric orthotopic liver transplant patient.

    abstract::We present a case report of a pediatric orthotopic liver transplant recipient who developed lymphoma with hypercalcemia on cyclosporine and prednisone immunosuppression. This is the first reported posttransplant lymphoproliferative disorder complicated by hypercalcemia, with a finding of an elevated 1,25 dihydroxyl vi...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198912000-00022

    authors: Nakazato P,Esquivel CO,Urbach AH,Makowka L,Scantlebury V,Jaffe R,Starzl TE

    更新日期:1989-12-01 00:00:00

  • Clear benefit of mycophenolate mofetil-based triple therapy in reducing the incidence of acute rejection after living donor renal transplantations.

    abstract:BACKGROUND:According to a pooled analysis of three randomized clinical studies concerning the prevention of acute rejection in cadaveric renal transplantation, mycophenolate mofetil (MMF) proved superior to azathioprine or placebo in conjunction with cyclosporine (CsA) and steroids. MMF-treated patients showed reduced ...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00007890-199908270-00023

    authors: Kim YS,Moon JI,Kim SI,Park K

    更新日期:1999-08-27 00:00:00

  • Measurement of renovascular circulating volume during hypothermic organ perfusion.

    abstract:BACKGROUND:Kidney donation after cardiac death leads to vascular damage as a result of warm ischemia, affecting renovascular circulating volume. Novel ultrasound dilution techniques may be used to measure renovascular circulating volumes during hypothermic machine perfusion of donor kidneys. METHODS:Renovascular circu...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31828a46f7

    authors: de Vries EE,van Smaalen TC,Boer J,Hoogland ER,Krivitski NM,Snoeijs MG,van Heurn LW

    更新日期:2013-05-15 00:00:00

  • The contribution of adhesion molecule expression in donor kidney biopsies to early allograft dysfunction.

    abstract:BACKGROUND:Renal allograft rejection is associated with the expression of adhesion molecules on vascular endothelial and tubular epithelial cells. METHODS:To assess whether the number of cell adhesion molecules expressed in donor kidneys can predict early rejection or delayed graft function, kidney biopsies from 20 li...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200106150-00028

    authors: Schwarz C,Regele H,Steininger R,Hansmann C,Mayer G,Oberbauer R

    更新日期:2001-06-15 00:00:00

  • Bovine islets are less susceptible than human islets to damage by human cytokines.

    abstract:BACKGROUND:The potential benefits of islet xenografting in type 1 diabetes include the intriguing, but still unanswered, possibility that the grafted xenoislets may be less subjected to human autoimmune attack. Cytokines may play a major role in the pathogenesis of autoimmune diabetes by causing impairment of insulin r...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200101150-00004

    authors: Piro S,Lupi R,Dotta F,Patanè G,Rabuazzo MA,Marselli L,Santangelo C,Realacci M,Del Guerra S,Purrello F,Marchetti P

    更新日期:2001-01-15 00:00:00

  • Alloimmunization-activated suppressor cells. II. In vitro activity of suppressor cells implicated in the abrogation of lethal graft-versus-host reaction.

    abstract::Incompatibility for DBA/2 (D2) minor histocompatibility antigens (MiHA) alone leads to a severe lethal graft-versus-host reaction (GVHR) in irradiated (D2 X B10.D2)F1 mice receiving a bone-marrow-plus-spleen-cell graft from B10.D2 donors. This mortality is abrogated when the donors are preimmunized simultaneously agai...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198309000-00016

    authors: Pritchard LL,Halle-Pannenko O

    更新日期:1983-09-01 00:00:00

  • Drug-Eluting Stents Versus Bare Metal Stents for Percutaneous Coronary Intervention in Kidney Transplant Recipients.

    abstract:BACKGROUND:The comparative effectiveness of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) versus bare metal stents (BMS) has not been studied in the kidney transplant population. METHODS:Using the US Renal Data System, we identified 3245 kidney transplant patients who underwent PCI between Ap...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001446

    authors: Lenihan CR,Montez-Rath ME,Winkelmayer WC,Chang TI

    更新日期:2017-04-01 00:00:00

  • Mitotic behaviour and proliferative metabolism in allogenic rat kidney transplants in the first 6 days after recirculation.

    abstract::Comparative experiments were performed on 41 allogenic rat kidney transplants to determine the mitotic behaviour and proliferative metabolism (application of 3H-thymidine) in the first 6 days after recirculation. Three days after transplantation, DNA synthesis in the tubular epithelial cells of the cortex and the medu...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197807010-00003

    authors: Lauschke H

    更新日期:1978-07-01 00:00:00

  • A method for early detection of graft failure in pancreas transplantation.

    abstract::Pancreatic transplantation is intended to normalize carbohydrate metabolism in insulin-dependent diabetics by restoring endogenous insulin release, and it is usually performed together with kidney transplantation in patients with end-stage renal failure. A major problem in these patients is the daily control of the gr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198304000-00016

    authors: Secchi A,Pontiroli AE,Traeger J,Dubernard JM,Touraine JL,Ruitton A,Blanc N,Pozza G

    更新日期:1983-04-01 00:00:00