A prospective randomized multicenter study of tacrolimus in combination with sirolimus in renal-transplant recipients.

Abstract:

BACKGROUND:Recently, sirolimus (SRL) was introduced as an immunosuppressant in solid-organ transplantation. This study evaluated combinations of SRL and tacrolimus (Tac). METHODS:This 6-month study investigated the safety and efficacy of Tac and steroids in combination with three different doses of SRL in renal-transplant recipients. A total of 104 patients were randomized in four groups: one group received Tac and steroids (control n=28), and three groups also received the following daily SRL doses: 0.5 mg (TacSRL0.5, n=25), 1 mg (TacSRL1, n=25), or 2 mg (TacSRL2, n=26). Tac doses were adjusted to whole-blood trough levels. Steroids were tapered from 20 mg per day to 5 mg per day. The SRL groups underwent a second randomization to discontinue SRL at either month 3 or 5. RESULTS:At month 6, patient survival rates were 100%, 100%, 96.0%, and 100%, and graft survival rates were 96.4%, 84.0%, 88.0%, and 84.6%, respectively. The overall safety profile was similar in all groups. The incidences of infections during months 1 to 3 were similar in all groups (control 46.4%, TacSRL0.5 32.0%, TacSRL1 56.0%, TacSRL2 46.2%). The 3-month incidences of hypercholesteremia (cholesterol >240 mg/dL or low-density lipoprotein cholesterol >160 mg/dL) were 21.4%, 36.0%, 48.0%, and 50.0% (P=0.019). Lipid levels improved after withdrawal of SRL. The 3-month incidences of biopsy-proven acute rejection were 28.6% (control), 8.0% (TacSRL0.5), 8.0% (TacSRL1), and 3.8% (TacSRL2) (P=0.014). CONCLUSION:Tac in combination with low doses of SRL provides a very effective and safe regimen.

journal_name

Transplantation

journal_title

Transplantation

authors

van Hooff JP,Squifflet JP,Wlodarczyk Z,Vanrenterghem Y,Paczek L

doi

10.1097/01.TP.0000071301.86299.75

subject

Has Abstract

pub_date

2003-06-27 00:00:00

pages

1934-9

issue

12

eissn

0041-1337

issn

1534-6080

journal_volume

75

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
  • Correlates and Outcomes of Low Physical Activity Posttransplant: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:Little is known about associations between low physical activity (PA) and its correlates and outcomes in solid organ transplant recipients. This systematic review with meta-analysis examined correlates and outcomes associated with low PA (ie, not meeting individual study's definition of being physically acti...

    journal_title:Transplantation

    pub_type: 杂志文章,meta分析

    doi:10.1097/TP.0000000000002543

    authors: Berben L,Engberg SJ,Rossmeissl A,Gordon EJ,Kugler C,Schmidt-Trucksäss A,Klem ML,Sereika SM,De Simone P,Dobbels F,De Geest SM,B-SERIOUS consortium.

    更新日期:2019-04-01 00:00:00

  • Cardiovascular risk profile of patients with acute liver failure after liver transplantation when compared with the general population.

    abstract:BACKGROUND:As opposed to most solid-organ transplant recipients, patients with acute liver failure exhibit a pretransplant health status more comparable with the general population, and any posttransplant cardiovascular risk excess should thus be more attributable to transplantation-related factors alone. METHODS:This...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181bcd682

    authors: Aberg F,Jula A,Höckerstedt K,Isoniemi H

    更新日期:2010-01-15 00:00:00

  • The role of resident accessory cells in corneal allograft rejection in the rabbit.

    abstract::Corneal grafts are more likely to be rejected when placed in a vascularized rather than in a normal host cornea. Using immunohistochemical techniques, normal rabbit cornea was found to contain measurable numbers of cells of hemopoietic origin, probably of either macrophage or dendritic lineage. After the deliberate in...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198612000-00017

    authors: Williams KA,Mann TS,Lewis M,Coster DJ

    更新日期:1986-12-01 00:00:00

  • Donor-specific T-cell reactivity identifies kidney transplant patients in whom immunosuppressive therapy can be safely reduced.

    abstract:BACKGROUND:To reduce the side effects of long-term immunosuppressive therapy, stable renal transplant patients were routinely converted from cyclosporine to either azathioprine or mycophenolate mofetil. Thereafter, the azathioprine and mycophenolate mofetil dose was reduced to 75% at 4 months and to 50% at 8 months aft...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: van Besouw NM,van der Mast BJ,de Kuiper P,Smak Gregoor PJ,Vaessen LM,IJzermans JN,van Gelder T,Weimar W

    更新日期:2000-07-15 00:00:00

  • Crossreactivity between human and canine Ia antigens using a mouse monoclonal antibody (CIA).

    abstract::A mouse monoclonal antibody (CIA) produced against human Ia antigens that reacts with 20-30% of human peripheral blood lymphocytes was found to react with more than 90% of dog lymphocytes. Less than 41% of the Ia-positive dog lymphocytes expressed surface immunoglobulins. Immunoprecipitation studies with 125I-labeled ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198308000-00016

    authors: Iwaki Y,Terasaki PI,Kinukawa T,Thai TH,Root T,Billing R

    更新日期:1983-08-01 00:00:00

  • Major histocompatibility complex control of NK-related allogeneic lymphocyte cytotoxicity in rats. The contributions of strong and medial transplantation antigens.

    abstract::Allogeneic lymphocyte cytotoxicity (ALC) describes the elimination of allogeneic lymphocytes in vivo by an NK-related activity. There is evidence that ALC is demonstrable between donor and recipient when these are incompatible at MHC gene loci alone. Since ALC is a property of T cell-deficient nude rats, the role of t...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198811000-00025

    authors: Ager A,Fajumi J,Sparshott SM,Ford WL,Butcher GW

    更新日期:1988-11-01 00:00:00

  • Fungal infections in liver transplant recipients.

    abstract::Sixty-two adults who underwent orthotopic liver transplantations between February 1981 and June 1983 were followed for a mean of 170 days after the operation. Twenty-six patients developed 30 episodes of significant fungal infection. Candida species and Torulopsis glabrata were responsible for 22 episodes and Aspergil...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198510000-00002

    authors: Wajszczuk CP,Dummer JS,Ho M,Van Thiel DH,Starzl TE,Iwatsuki S,Shaw B Jr

    更新日期:1985-10-01 00:00:00

  • Natural killer cell- and macrophage mediated discordant guinea pig-->rat xenograft rejection in the absence of complement, xenoantibody and T cell immunity.

    abstract:BACKGROUND:The role of natural killer (NK) cells and macrophages (Møs) in the absence of T cell immunity in discordant xenograft (xg) rejection was investigated. METHODS:Guinea pig hearts were transplanted into athymic nude rats receiving no treatment or antixenoantibody (xAb), anticomplement (C), antinatural killer (...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Xia G,Ji P,Rutgeerts O,Waer M

    更新日期:2000-07-15 00:00:00

  • Clinical presentation of hepatic artery thrombosis after liver transplantation in the cyclosporine era.

    abstract::Hepatic artery thrombosis is a dreadful complication of orthotopic liver transplantation. It should be suspected in cases of fulminant liver failure, delayed bile leak, or intermittent sepsis of unknown cause after liver transplantation. Accurate diagnosis is assisted by ultrasound and computerized tomography scans, b...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198512000-00019

    authors: Tzakis AG,Gordon RD,Shaw BW Jr,Iwatsuki S,Starzl TE

    更新日期:1985-12-01 00:00:00

  • Preoperative factors associated with outcome and their impact on resource use in 1148 consecutive primary liver transplants.

    abstract:BACKGROUND:Hepatic transplantation is a highly effective but costly treatment for end-stage hepatic dysfunction. One approach to improve efficiency in the use of scarce organs for transplantation is to identify preoperative factors that are associated with poor outcome posttransplantation. This may assist both in selec...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200109270-00023

    authors: Markmann JF,Markmann JW,Markmann DA,Bacquerizo A,Singer J,Holt CD,Gornbein J,Yersiz H,Morrissey M,Lerner SM,McDiarmid SV,Busuttil RW

    更新日期:2001-09-27 00:00:00

  • Potential therapeutic interventions to avoid or treat chronic allograft dysfunction.

    abstract::Despite the significant improvements that have occurred since the introduction of CsA, long-term renal allograft survival continues to be an area of concern. Management strategies that involve the use of sirolimus offer some promise. A number of observations suggest that sirolimus may have the ability to reduce the ra...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:

    authors: Kahan BD

    更新日期:2001-06-15 00:00:00

  • In Vivo Costimulation Blockade-Induced Regulatory T Cells Demonstrate Dominant and Specific Tolerance to Porcine Islet Xenografts.

    abstract:BACKGROUND:Although islet xenotransplantation is a promising therapy for type 1 diabetes, its clinical application has been hampered by cellular rejection and the requirement for high levels of immunosuppression. The aim of this study was to determine the role of Foxp3 regulatory T (Treg) cells in costimulation blockad...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001482

    authors: Wu J,Hu M,Qian YW,Hawthorne WJ,Burns H,Liuwantara D,Alexander SI,Yi S,O'Connell PJ

    更新日期:2017-07-01 00:00:00

  • Cariporide (HOE-642) improves cardiac allograft preservation in a porcine model of orthotopic heart transplantation.

    abstract:BACKGROUND:Acute graft dysfunction caused by ischemia-reperfusion injury is recognized as a major source of morbidity and mortality following adult heart transplantation. The aim of this study was to determine whether treating the donor and recipient with cariporide, an inhibitor of the sodium-hydrogen exchanger, could...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000054619.13962.30

    authors: Ryan JB,Hicks M,Cropper JR,Garlick SR,Kesteven SH,Wilson MK,Feneley MP,Macdonald PS

    更新日期:2003-03-15 00:00:00

  • Bone mineral density changes within six months of renal transplantation.

    abstract:BACKGROUND:The effective use of new steroid-sparing immunosuppressive regimens may lower cumulative glucocorticoid use among renal transplant recipients. However, it is unknown what effect this therapeutic trend has had on bone disease. METHODS:Unselected newly transplanted inpatients (n=45) were identified and compre...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200301150-00009

    authors: Mikuls TR,Julian BA,Bartolucci A,Saag KG

    更新日期:2003-01-15 00:00:00

  • Donor treatment with mycophenolate mofetil: protection against ischemia-reperfusion injury in the rat.

    abstract:BACKGROUND:Mycophenolic acid, the active metabolite of mycophenolate mofetil, inhibits the glycosylation of cell membrane glycoproteins. We hypothesized that impaired glycosylation of cell adhesion molecules on endothelial cells in vivo results in decreased susceptibility to inflammation or immunogenicity after allogen...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200002150-00006

    authors: Valentin JF,Bruijn JA,Paul LC

    更新日期:2000-02-15 00:00:00

  • Laparoscopic live donor nephrectomy.

    abstract::A laparoscopic live-donor nephrectomy was performed on a 40-year-old man. The kidney was removed intact via a 9-cm infraumbilical midline incision. Warm ischemia was limited to less than 5 min. Immediately upon revascularization, the allograft produced urine. By the second postoperative day, the recipient's serum crea...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Ratner LE,Ciseck LJ,Moore RG,Cigarroa FG,Kaufman HS,Kavoussi LR

    更新日期:1995-11-15 00:00:00

  • Quantification of the islet product: presentation of a standardized current good manufacturing practices compliant system with minimal variability.

    abstract:BACKGROUND:Accurate islet quantification has proven difficult to standardize in a good manufacturing practices (GMP) approved manner. METHODS:The influence of assessment variables from both manual and computer-assisted digital image analysis (DIA) methods were compared using calibrated, standardized microspheres or is...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31820ae48e

    authors: Friberg AS,Brandhorst H,Buchwald P,Goto M,Ricordi C,Brandhorst D,Korsgren O

    更新日期:2011-03-27 00:00:00

  • Magnetic resonance of the hepatic veins with angular reconstruction: application in living-related liver transplantation.

    abstract:BACKGROUND:Preoperative mapping of the hepatic venous system of the partial liver graft is indispensable to the success of living-related liver transplantation. We assessed the accuracy of magnetic resonance (MR) venography with angular reconstruction in depicting the tributaries of the middle hepatic vein and left hep...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199907270-00019

    authors: Cheng YF,Chen CL,Huang TL,Chen TY,Lee TY,Chen YS,Wang CC,de Villa V,Goto S,Chiang YC,Eng HL,Jawan B,Cheung HK

    更新日期:1999-07-27 00:00:00

  • Impact of Rural Residence on Kidney Transplant Rates Among Waitlisted Candidates in the VA Transplant Programs.

    abstract:BACKGROUND:Although proportionally more veterans live in rural areas compared to nonveterans, the impact of rurality status on kidney transplantation (KTP) access among veterans is unknown. Our objective was to study KTP rates among veterans listed for KTP and to compare the impact of rurality status on KTP rates among...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002624

    authors: O'Shea AMJ,Franciscus CL,Kaboli PJ,Kalil RS

    更新日期:2019-09-01 00:00:00

  • Hemorrhagic cystitis after bone marrow transplantation. Risk factors and complications.

    abstract::Hemorrhagic cystitis (HC) is a major cause of morbidity after BMT; we have analyzed its incidence, risk factors, and complications in 977 patients undergoing BMT between 1974 and 1988. Despite vigorous hydration and frequent voiding in all patients receiving cyclophosphamide, 135/977 (15% by Kaplan-Meier projection) d...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199310000-00020

    authors: Sencer SF,Haake RJ,Weisdorf DJ

    更新日期:1993-10-01 00:00:00

  • Preservation of Microvascular Integrity in Murine Orthotopic Tracheal Allografts by Clopidogrel.

    abstract:BACKGROUND:Survival after lung transplantation is mainly limited by the development of chronic lung allograft dysfunction (CLAD). The aim of this study was to investigate if platelet inhibition by clopidogrel has a functionally relevant influence on the microvascular integrity of orthotopic tracheal allografts as an an...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002571

    authors: Heim C,Khan MA,von Silva-Tarouca B,Kuckhahn A,Stamminger T,Ramsperger-Gleixner M,Nicolls MR,Weyand M,Ensminger SM

    更新日期:2019-05-01 00:00:00

  • Role of anti-tumor necrosis factor-alpha in ischemia/reperfusion injury in isolated rat liver in a blood-free environment.

    abstract:BACKGROUND:Warm ischemia/reperfusion injury during liver transplantation is the most important cause of primary nonfunction of liver allografts. Tumor-necrosis factor (TNF)-alpha apparently mediates tissue damage by inducing apoptosis and/or necrosis in liver transplants. The aim of the study was to determine, using an...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200206270-00004

    authors: Ben-Ari Z,Hochhauser E,Burstein I,Papo O,Kaganovsky E,Krasnov T,Vamichkim A,Vidne BA

    更新日期:2002-06-27 00:00:00

  • Expression of HLA system antigens on placenta.

    abstract::The levels of HLA-A and -B antigens expressed by placenta have been assessed relative to parental and other A and B antigen types that were not shared by the foetus. A purified preparation of placenta plasma membrane was used to estimate the antigen activities. The results indicate that maternally and paternally inher...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197612000-00009

    authors: Goodfellow PN,Barnstable CJ,Bodmer WF,Snary D,Crumpton MJ

    更新日期:1976-12-01 00:00:00

  • Treatment of patients with recurrent hepatitis C after liver transplantation with peginterferon alfa-2B plus ribavirin.

    abstract:BACKGROUND:Recurrent hepatitis C virus (HCV) after liver transplantation (OLT) is a major cause of graft loss in HCV-positive patients. In this study, we evaluated the efficacy and safety of pegylated interferon alfa-2b (peginterferon) and ribavirin treatment for recurrent HCV after OLT and analyzed the influence of an...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.tp.0000225827.18034.be

    authors: Neumann U,Puhl G,Bahra M,Berg T,Langrehr JM,Neuhaus R,Neuhaus P

    更新日期:2006-07-15 00:00:00

  • Tolerance induction in a fully allogeneic combination using anti-T cell receptor-alpha beta monoclonal antibody, low dose irradiation, and donor bone marrow transfusion.

    abstract::In a murine strain combination disparate in both H-2 antigens and minor histocompatibility antigens consisting of C57BL/6 (B6; H-2b, Mls-1b) mice as recipients and AKR/J (AKR; H-2k, Mls-1a) mice as donors, we reported that the administration of anti-TCR-alpha beta mAb nonspecifically suppresses the ability to reject a...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: Nomoto K,Yung-Yun K,Omoto K,Umesue M,Murakami Y,Matsuzaki G,Nomoto K

    更新日期:1995-02-15 00:00:00

  • Endogenous interleukin 1 receptor antagonist during human bone marrow transplantation: increased levels during graft-versus-host disease, during infectious complications, and after immunoglobulin therapy.

    abstract::In order to understand in more detail the role of endogenous interleukin 1 receptor antagonist (IL-1ra) during bone marrow transplantation, IL-1ra serum levels of 28 patients undergoing allogeneic (n=25) or autologous (n=3) bone marrow transplantation were measured with a commercially available ELISA. In addition, the...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199701150-00010

    authors: Schwaighofer H,Oberhuber G,Hebart H,Einsele H,Herold M,Nachbaur D,Eibl B,Tilg H,Kropshofer G,Ferrara JL,Niederwieser D

    更新日期:1997-01-15 00:00:00

  • Studies on the induction and expression of T cell-mediated immunity. V. Lectin-induced nonspecific cell-mediated cytotoxicity by alloimmune lymphocytes.

    abstract::Murine lymphoid cells sensitized against allografts express two types of cytotoxicity measured in vitro in short-term assays of 2 to 3 hr by 51Cr release. One type of cytotoxicity is specific against target cells carrying the sensitizing alloantigens, and the other type is nonspecific against both syngeneic and unrela...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197602000-00002

    authors: Bonavida B,Bradley TP

    更新日期:1976-02-01 00:00:00

  • Induction immunosuppression.

    abstract::Induction immunosuppression is intense, prophylactic therapy used at the time of transplantation based on the empiric observation that more powerful immunosuppression is required to prevent acute rejection early. In the past decade, there has been a growing trend towards the use of specialized agents such as antibody ...

    journal_title:Transplantation

    pub_type: 社论,评审

    doi:10.1097/01.tp.0000234905.56926.7f

    authors: Kirk AD

    更新日期:2006-09-15 00:00:00

  • Transgenic Expression of Human CD46 on Porcine Endothelium: Effect on Coagulation and Fibrinolytic Cascades During Ex Vivo Human-to-Pig Limb Xenoperfusions.

    abstract:BACKGROUND:Dysregulation of the coagulation system due to inflammatory responses and cross-species molecular incompatibilities represents a major obstacle to successful xenotransplantation. We hypothesized that complement inhibition mediated by transgenic expression of human CD46 in pigs might also regulate the coagula...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000746

    authors: Bongoni AK,Kiermeir D,Schnider J,Jenni H,Garimella P,Bähr A,Klymiuk N,Wolf E,Ayares D,Voegelin E,Constantinescu MA,Seebach JD,Rieben R

    更新日期:2015-10-01 00:00:00

  • Reasons for non-use of recovered kidneys: the effect of donor glomerulosclerosis and creatinine clearance on graft survival.

    abstract:BACKGROUND:In 2000, the United Network for Organ Sharing/Organ Procurement and Transplantation Network Registry reported 540 recovered kidneys were discarded because of biopsy results, and 210 were discarded because of poor organ function. We compared the percentage of glomerulosclerosis (GS) and creatinine clearance (...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000123080.19145.59

    authors: Edwards EB,Posner MP,Maluf DG,Kauffman HM

    更新日期:2004-05-15 00:00:00