Tacrolimus or cyclosporine: which is the better partner for mycophenolate mofetil in heart transplant recipients?

Abstract:

BACKGROUND:The aim of this single-center study was to investigate whether trough level adjusted mycophenolate mofetil (MMF) is more efficacious in combination with tacrolimus (TAC) or cyclosporine (CsA) and to evaluate the impact of either drug on MMF dosage. METHODS:Sixty patients (TAC, n = 30; CsA, n = 30) undergoing heart transplantation were randomized into a prospective, open-label, controlled trial. Immunosuppression consisted of TAC or CsA in combination with MMF and corticosteroids. Target blood trough levels of TAC, CsA, and mycophenolic acid (MPA) were in the range of 10 to 15 ng/mL, 100 to 300 ng/mL, and 1.5 to 4.0 microg/mL, respectively. Acute rejection episodes (ARE); survival data; and adverse events with a special emphasis on infections, diabetes, hypertension, hypercholesterolemia, and the development of graft vessel disease (GVD) were recorded. RESULTS:Baseline characteristics were well balanced. All patients were successfully withdrawn from corticosteroids within 6 months of transplant. Freedom from acute rejection was significantly higher (P = 0.0001) and the incidence of ARE per 100 patient days significantly lower in the TAC-MMF group than in the CsA-MMF group (0.03 vs. 0.15; P = 0.00007). Overall patient survival during follow-up was similar (93% vs. 90%). To achieve the targeted MPA blood levels, a significantly lower dose of MMF was required for TAC versus CsA patients. After a follow-up time of 2 years, the mean GVD score was 1.85 +/- 3.18 in the TAC-MMF group and 3.95 +/- 4.8 in the CsA-MMF group (P = 0.08). CONCLUSIONS:At the selected doses and target levels for TAC and CsA used in this study, trough level adjusted MMF was more efficacious in combination with TAC for prevention of ARE. Furthermore, CsA patients need significantly more MMF to achieve similar MPA levels.

journal_name

Transplantation

journal_title

Transplantation

authors

Meiser BM,Groetzner J,Kaczmarek I,Landwehr P,Müller M,Jung S,Uberfuhr P,Fraunberger P,Stempfle HU,Weis M,Reichart B

doi

10.1097/01.tp.0000129814.52456.25

subject

Has Abstract

pub_date

2004-08-27 00:00:00

pages

591-8

issue

4

eissn

0041-1337

issn

1534-6080

journal_volume

78

pub_type

临床试验,杂志文章,随机对照试验
  • The Impact of Performance Status on Length of Hospital Stay and Clinical Complications Following Liver Transplantation.

    abstract:BACKGROUND:Impaired pretransplant performance status (PS) is associated with chronic liver disease (CLD). We studied its impact on hospital length of stay (LOS), complications and readmissions in the first year after liver transplantation. METHOD:The Standard National Liver Transplant Registry was linked to a hospital...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000003484

    authors: Wallace D,Cowling TE,Walker K,Suddle A,Gimson A,Rowe I,Callaghan C,Heaton N,van der Meulen J,Bernal W

    更新日期:2020-10-08 00:00:00

  • Zinc transporter 8 autoantibodies increase the predictive value of islet autoantibodies for function loss of technically successful solitary pancreas transplant.

    abstract:BACKGROUND:Despite the success rate of solitary pancreas transplantation in type 1 diabetes with preserved kidney function has greatly improved in recent years, a residual proportion of failures persists. METHODS:With the aim of investigating autoimmunity as an unrecognized cause of graft failure, we measured autoanti...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31822ae65f

    authors: Occhipinti M,Lampasona V,Vistoli F,Bazzigaluppi E,Scavini M,Boggi U,Marchetti P,Bosi E

    更新日期:2011-09-27 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

  • Increase of proliferating renal progenitor cells in acute tubular necrosis underlying delayed graft function.

    abstract:BACKGROUND:Delayed graft function (DGF) is associated with acute tubular necrosis. In this setting, surviving tubular cells may proliferate and replace injured cells. CD133Pax-2cells may play a role in the regeneration of tubular damage. The aim of this study was to demonstrate the presence of these cells in human kidn...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31816a8891

    authors: Loverre A,Capobianco C,Ditonno P,Battaglia M,Grandaliano G,Schena FP

    更新日期:2008-04-27 00:00:00

  • Tools for human leukocyte antigen antibody detection and their application to transplanting sensitized patients.

    abstract::In recent years there have been major advances in the technology for the detection and definition of human leukocyte antigen antibodies. In this overview we describe the evolution in laboratory technology, the techniques currently available and consider their application in antibody specificity definition and in under...

    journal_title:Transplantation

    pub_type: 社论,评审

    doi:10.1097/TP.0b013e31817c90f5

    authors: Fuggle SV,Martin S

    更新日期:2008-08-15 00:00:00

  • Granulocyte/macrophage colony-stimulating factor-stimulated hepatic dendritic cell progenitors prolong pancreatic islet allograft survival.

    abstract::Liver-derived dendritic cell (DC) progenitors propagated in liquid culture in granulocyte/macrophage colony-stimulating factor exhibit low levels both of cell surface MHC class II antigens and of counter-receptors for CTLA-4/CD28. They fail to stimulate allogeneic T cells in mixed leukocyte cultures. To evaluate their...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Rastellini C,Lu L,Ricordi C,Starzl TE,Rao AS,Thomson AW

    更新日期:1995-12-15 00:00:00

  • Hepatic artery pseudoaneurysm after liver transplantation: treatment with percutaneous thrombin injection.

    abstract::Pseudoaneurysms of the hepatic artery are a rare complication of liver transplantation. Early diagnosis and treatment are essential to avoid life-threatening hemorrhage. Conventional treatment consists of surgical resection and vascular reconstruction or transarterial coil embolization. More recently, percutaneous thr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000063936.94587.10

    authors: Patel JV,Weston MJ,Kessel DO,Prasad R,Toogood GJ,Robertson I

    更新日期:2003-05-27 00:00:00

  • Skin-autofluorescence is an independent predictor of graft loss in renal transplant recipients.

    abstract:BACKGROUND:Skin-autofluorescence (skin-AF) noninvasively measures the tissue accumulation of advanced glycation end products (AGEs). AGEs are nephrotoxic and potential effectors of cardiovascular mortality. We investigated whether skin-AF predicted graft loss after kidney transplantation. METHODS:A total of 302 renal ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31819d3173

    authors: Hartog JW,Gross S,Oterdoom LH,van Ree RM,de Vries AP,Smit AJ,Schouten JP,Nawroth PP,Gans RO,van Son WJ,Bierhaus A,Bakker SJ

    更新日期:2009-04-15 00:00:00

  • Peripheral blood mononuclear cell responses from type 1 diabetic patients and subjects at-risk for type 1 diabetes to human fetal pancreatic tissue proteins.

    abstract:BACKGROUND:Fetal pancreatic tissue has been suggested to be less immunogenic than adult islets. Thus, transplantation of human fetal pancreatic tissue as treatment for type 1 diabetes has been gaining interest. To investigate this question, we tested the peripheral blood mononuclear cell (PBMC) responses from different...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200005150-00028

    authors: Brooks-Worrell BM,Peterson KP,Peterson CM,Palmer JP,Jovanovic L

    更新日期:2000-05-15 00:00:00

  • Benefit of phosphodiesterase 4 inhibitors as supplemental therapy after lung transplantation concerning their antiproliferative effects: an experimental study using a heterotopic rodent model.

    abstract:BACKGROUND:Recent advances in the understanding of immunomodulatory properties of phosphodiesterase 4 (PDE4) inhibitors recommend these drugs for immunosuppressive therapy after lung transplantation. The potency of three PDE4 inhibitors was tested using an established model of heterotopic tracheal transplantation in ra...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200208150-00007

    authors: Schade I,Roth-Eichhorn S,Kasper M,Kuss H,Plötze K,Funk RH,Schüler S

    更新日期:2002-08-15 00:00:00

  • Indirect allorecognition of major histocompatibility complex allopeptides in human renal transplant recipients with chronic graft dysfunction.

    abstract:BACKGROUND:It has been suggested that T cells primed by processed donor major histocompatibility complex antigen (the "indirect" pathway of allorecognition) may be responsible for mediating chronic allograft rejection. The purpose of this study was to develop a clinically useful assay to study the occurrence of indirec...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199709270-00001

    authors: Vella JP,Spadafora-Ferreira M,Murphy B,Alexander SI,Harmon W,Carpenter CB,Sayegh MH

    更新日期:1997-09-27 00:00:00

  • Cytotoxic and agglutinating H-Y antibodies in multiparous female mice.

    abstract::Pregnancy in inbred mice is associated with long-term accceptance of H-Y-incompatible skin grafts (in some "rejector" strain females) and with the formation of cytotoxic and agglutinating H-Y antibodies (in females generally). Yet there is no evident correlation between the two phenomena; postpartum females of nonreje...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Krupen-Brown K,Wachtel SS

    更新日期:1979-06-01 00:00:00

  • Effect of asialofetuin on prolongation of skin allograft survival by donor bone marrow cells.

    abstract::Survival of skin allografts made to antilymphocyte serum (ALS)-treated recipients is prolonged by posttransplant intravenous injection of donor strain bone marrow cells (BMC). If asialofetuin (ASF) is coinjected with the BMC, the prolonged graft survival is augmented (e.g., median survival time increased from 43 days ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199402150-00022

    authors: Khouri W,Masli S,De Fazio SR,Gozzo JJ

    更新日期:1994-02-01 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

  • Long-term islet graft survival in streptozotocin- and autoimmune-induced diabetes models by immunosuppressive and potential insulinotropic agent FTY720.

    abstract:BACKGROUND:Toxicity of current immunosuppressive agents to islet grafts is one of the major obstacles to clinical islet transplantation (Tx). This study was designed to assess the efficacy of FTY720, a novel immunomodulator with a unique mechanism of action, on islet graft survival and function in streptozotocin (STZ)-...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200205150-00011

    authors: Fu F,Hu S,Deleo J,Li S,Hopf C,Hoover J,Wang S,Brinkmann V,Lake P,Shi VC

    更新日期:2002-05-15 00:00:00

  • Kidney Transplant in the Era of Modern Therapy for Multiple Myeloma.

    abstract::Chronic kidney disease is common in patients with multiple myeloma. Historically, individuals with end-stage renal disease and multiple myeloma did poorly with renal transplantation due to higher mortality rates from the malignancy itself or associated comorbidities. However, over the past 2 decades, there have been s...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000002449

    authors: Huskey JL,Heilman RL,Khamash H,Fonseca R

    更新日期:2018-12-01 00:00:00

  • Long-term outcome of controlled, non-heart-beating donor liver transplantation.

    abstract:BACKGROUND:Previous reports have established the feasibility of using livers from controlled, non-heart-beating donors (CNHBD) with good immediate graft function. This has been largely borne out of necessity because of the donor shortage. METHODS:Retrospective database review for the last 7 years (1995-2002), encompas...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000128327.95311.e3

    authors: Manzarbeitia CY,Ortiz JA,Jeon H,Rothstein KD,Martinez O,Araya VR,Munoz SJ,Reich DJ

    更新日期:2004-07-27 00:00:00

  • Quantitative polymerase chain reaction profiling of immunomarkers in rejecting kidney allografts for predicting response to steroid treatment.

    abstract:BACKGROUND:Steroid-resistant acute rejection is a risk factor for inferior renal allograft outcome. METHODS:From 873 kidney transplant recipients (1995-2005), 108 patients with a first rejection episode were selected for study using strict inclusion criteria and clinical endpoint definition. We aimed to predict respon...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31825db651

    authors: Rekers NV,Bajema IM,Mallat MJ,Zuidwijk K,Anholts JD,Goemaere N,Haasnoot GW,van Groningen MC,van Kooten C,de Fijter JW,Claas FH,Eikmans M

    更新日期:2012-09-27 00:00:00

  • Effect of HLA matching on organ distribution among whites and African-Americans.

    abstract::A total of 159 patients received renal cadaveric grafts under 2 different allocation systems. System 1, a local variance (i.e., a point system different from that of United Network for Organ Sharing [UNOS]), and system 2, the current UNOS point system, differed in the relative emphasis on waiting time and HLA match. T...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Zachary AA,Braun WE,Hayes JM,McElroy JB,Novick AC,Schulak JA,Sharp WV

    更新日期:1994-04-15 00:00:00

  • Controlled Oxygenated Rewarming of Cold Stored Livers Prior to Transplantation: First Clinical Application of a New Concept.

    abstract:BACKGROUND:Abrupt temperature shift from hypothermia to normothermia incurred on reperfusion of organ grafts has been delineated as a genuine factor contributing to reperfusion injury and graft dysfunction after transplantation. METHODS:In a first clinical series of 6 patients, cold-stored livers, all allocated by the...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000915

    authors: Hoyer DP,Mathé Z,Gallinat A,Canbay AC,Treckmann JW,Rauen U,Paul A,Minor T

    更新日期:2016-01-01 00:00:00

  • Are indoleamine-2,3-dioxygenase producing human dendritic cells a tool for suppression of allogeneic T-cell responses?

    abstract:BACKGROUND:Suppressive dendritic cells (DCs) are a promising tool for tolerance induction in transplantation. A human DCs subpopulation, which constitutively expresses indoleamine-2,3-dioxygenase (IDO), a molecule shown to prevent the rejection of fetus during pregnancy, has recently been described. This subset, charac...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000251646.09702.ec

    authors: Löb S,Ebner S,Wagner S,Weinreich J,Schäfer R,Königsrainer A

    更新日期:2007-02-27 00:00:00

  • Specific tolerance and immunocompetence in haploidentical, but not in completely allogeneic, canine chimeras treated with methotrexate and cyclosporine.

    abstract::Recipient dogs were conditioned with 9.2 Gy of total-body irradiation followed by the infusion of bone marrow and peripheral blood leukocytes from a DLA-haploidentical littermate (N = 10) or a completely allogeneic unrelated donor (n = 9). Graft-vs.-host disease (GVHD) prophylaxis consisted of methotrexate (MTX) and c...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198711000-00006

    authors: Deeg HJ,Severns E,Raff RF,Sale GE,Storb R

    更新日期:1987-11-01 00:00:00

  • Increased immune transcript levels are correlated with acute graft-versus-host disease and cytomegalovirus response after allogeneic stem cell transplantation.

    abstract:BACKGROUND:Donor T cells are primarily responsible for graft-versus-host disease (GVHD). Three effector pathways have been described for T-cell cytotoxicity: granzyme B/perforin, Fas/Fas ligand (FasL), and secreted molecules such as tumor necrosis factor (TNF)-alpha. Therefore, this study evaluates the gene expression ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000100465.83529.42

    authors: Jaksch M,Remberger M,Mattsson J

    更新日期:2004-01-27 00:00:00

  • Results of a prospective randomized trial of sirolimus conversion in kidney transplant recipients on early corticosteroid withdrawal.

    abstract:BACKGROUND:The use of calcineurin inhibitors is associated with chronic nephrotoxicity and lower glomerular filtration rate (GFR). As a result, one strategy of transplant immunosuppression is calcineurin inhibitor elimination. METHODS:The aim of this study was to determine the outcome of a prospective randomized trial...

    journal_title:Transplantation

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/TP.0b013e31822805d7

    authors: Heilman RL,Younan K,Wadei HM,Mai ML,Reddy KS,Chakkera HA,Gonwa TA

    更新日期:2011-10-15 00:00:00

  • Small Split Pediatric Kidneys to Expand the Donor Pool: An Analysis of Scientific Registry of Transplant Recipients (SRTR) Data.

    abstract:BACKGROUND:Increased use of pediatric deceased donor kidneys could enlarge the deceased donor kidney pool. Kidney transplant outcomes from small pediatric donors were compared with those from ideal kidney (IK) and expanded criteria kidney (ECK) donors to understand the optimal use of pediatric donor kidneys. METHODS:K...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/TP.0000000000002706

    authors: Suneja M,Kuppachi S,Katz D,Hunsicker L

    更新日期:2019-12-01 00:00:00

  • The UK scheme for mandatory continuous monitoring of early transplant outcome in all kidney transplant centers.

    abstract::Mandatory continuous monitoring of early transplant outcome with centralized oversight was introduced in 2004 for all 23 UK adult kidney transplant units. Risk-adjusted cumulative sum charts are used to assess 30-day graft and patient survival against past performance for each center, and change in transplant center p...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181b997de

    authors: Collett D,Sibanda N,Pioli S,Bradley JA,Rudge C

    更新日期:2009-10-27 00:00:00

  • Basic anatomical and physiological differences between species should be considered when choosing combinations for use in models of hepatic xenotransplantation: an investigation of the guinea pig-to-rat combination.

    abstract::Published data on the guinea pig-to-rat hepatic xenotransplant model describe problems concerning poor graft reperfusion. To further investigate this phenomenon, orthotopic liver xenotransplantation between weight-matched guinea pigs and rats were performed using Kamada's technique. On reperfusion, all cases had porta...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199807150-00017

    authors: Delriviere LD,Havaux X,Gibbs P,Gianello PR

    更新日期:1998-07-15 00:00:00

  • Long-term survival of DLA-matched segmental small-bowel allografts in dogs.

    abstract::The aim of this study was to investigate the combined effect of DLA matching and immunosuppressive therapy on the survival of segmental small-bowel allografts in dogs. Orthotopic segmental small-bowel transplantations (25 to 30% of total small bowel length) were performed in two stages: first a heterotopic segmental s...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199311000-00002

    authors: Meijssen MA,Heineman E,de Bruin RW,Wolvekamp MC,Marquet RL,Molenaar JC

    更新日期:1993-11-01 00:00:00

  • Preventing acute rejection, Epstein-Barr virus infection, and posttransplant lymphoproliferative disorders after kidney transplantation: use of aciclovir and mycophenolate mofetil in a steroid-free immunosuppressive protocol.

    abstract:BACKGROUND:A widely held view is that any increase in the potency of an immunosuppressive agent will lead to an increase in infection and malignancy, such as life-threatening Epstein-Barr virus (EBV) induced posttransplant lymphoproliferative disorders (PTLD). We tested this paradigm by studying the effect of adding mo...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/00007890-199905150-00002

    authors: Birkeland SA,Andersen HK,Hamilton-Dutoit SJ

    更新日期:1999-05-15 00:00:00

  • A sensitive micromethod for generating and assaying allogeneically induced cytotoxic human lymphocytes.

    abstract::A sensitive micromethod for generating and assaying allogeneically induced cytotoxic human lymphocytes in vitro is described. Responding lymphocytes are cultured with mitomycin-C treated allogeneic stimulating cells in wells of replicate microtrays for both one-way mixed leukocyte culture (MLC) and cell-mediated lymph...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197606000-00005

    authors: Zarling JM,McKeough M,Bach FH

    更新日期:1976-06-01 00:00:00