Short-term combination of mycophenolate mofetil with cyclosporine as a therapeutic option for renal transplant recipients: A prospective, multicenter, randomized study.

Abstract:

BACKGROUND:Mycophenolate mofetil (MMF), compared to azathioprine (AZA), reduces acute rejection and treatment failure in cyclosporine (CsA) and steroid regimens, but its effect on graft survival is unproven from prospective studies and prolonged use is costly. This study evaluated the efficacy and tolerability of replacing MMF by AZA after 3 months. METHODS:This 28 center, prospective, 12-month, parallel group, open-label study, randomized patients to three groups with microemulsion formulation of CsA (ME-CsA) and steroids as baseline therapy. Group 1 (n=158) received MMF for 3 months, replaced by AZA for 9 months; group 2 (n=162) received MMF for 12 months; and group 3 (n=157) received AZA for 12 months. RESULTS:Treatment failure and the cumulative rate of acute rejection were significantly lower in the MMF groups compared with the AZA group (P=0.007 and P=0.03, respectively). Graft loss, death, and safety profiles of all three treatments were similar over 12 months, as were mean serum creatinine levels. Switching from MMF to AZA did not affect treatment failure. No patient in group 1 experienced a recurrent rejection after month 3, one patient died, and nine patients experienced first rejection episodes. Most rejections (6/9) were steroid-sensitive and histologically mild. CONCLUSIONS:Replacement of MMF by AZA after 3 months of therapy with ME-CsA and steroids provides comparable efficacy and safety profiles to continuous MMF over 12 months. Although apparently a cost-effective option, long-term studies are required to assess the benefit/risk ratio of this therapy switch in different patient subpopulations.

journal_name

Transplantation

journal_title

Transplantation

authors

Sadek S,Medina J,Arias M,Sennesael J,Squifflet JP,Vogt B,Neo Int-05 Study group.

doi

10.1097/00007890-200208270-00013

subject

Has Abstract

pub_date

2002-08-27 00:00:00

pages

511-7

issue

4

eissn

0041-1337

issn

1534-6080

journal_volume

74

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
  • Prevention of autoimmune diabetes by FTY720 in nonobese diabetic mice.

    abstract:BACKGROUND:FTY720 prevents allograft rejection with remarkable potency without inducing generalized immunosuppression. We determined the effect of FTY720 on development of autoimmune diabetes in nonobese diabetic (NOD) mice. METHODS:NOD mice were given FTY720 (0.5 mg/kg, orally) five times per week starting from 4 wee...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200212270-00006

    authors: Maki T,Gottschalk R,Monaco AP

    更新日期:2002-12-27 00:00:00

  • Should All Status 1A Patients Be Prioritized Over High MELD Patients? Concept of Risk Stratification in Extremely Ill Liver Transplant Recipients.

    abstract:BACKGROUND:Status 1A patients are prioritized over liver disease patients regardless of Model for End-stage Liver Disease (MELD) score. We aimed to identify groups with high waitlist mortality in Status 1A and MELD ≥40 patients to determine who would most benefit from transplantation. METHODS:Data on patients listed a...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002651

    authors: Safwan M,Nwagu U,Collins K,Abouljoud M,Nagai S

    更新日期:2019-10-01 00:00:00

  • Ontogeny of suppressor cells. II. Suppression of graft-versus-host and mixed leukocyte culture responses by embryonic cells.

    abstract::Ontogenic development of suppressor cells was studied in mouse embryos. It was found that liver cells of embryos at various stages of gestation were capable of interfering with the mixed leukocyte culture (MLC) reaction. The MLC reaction was also inhibited by embryonic spleen and thymus cells. However, the latter were...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197812000-00016

    authors: Globerson A,Umiel T

    更新日期:1978-12-01 00:00:00

  • Advantages of cyclosporine as sole immunosuppressive agent in children with transplanted kidneys.

    abstract::A prospective study of intentional stopping of steroids 6 months after transplantation was done with 29 pediatric renal transplant recipients with a mean age of 10.4 +/- 3.4 years. Immunosuppression consisted of cyclosporine and methylprednisolone. We stopped giving MP to 24 children: to twenty after six months, four ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199211000-00013

    authors: Ghio L,Tarantino A,Edefonti A,Mocciaro A,Giani M,Guerra L,Berardinelli L,Vegeto A

    更新日期:1992-11-01 00:00:00

  • B cells in cluster or in a scattered pattern do not correlate with clinical outcome of renal allograft rejection.

    abstract:BACKGROUND:The role of CD20+ B cells in renal allograft rejection has been reappreciated. Importantly, recent studies suggest a relation between CD20+ B cell aggregates and poorer clinical outcome. In the present study, we attempted to confirm these early reports in a tightly controlled patient population and to differ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181860a74

    authors: Scheepstra C,Bemelman FJ,van der Loos C,Rowshani AT,van Donselaar-Van der Pant KA,Idu MM,ten Berge IJ,Florquin S

    更新日期:2008-09-27 00:00:00

  • The importance of the effect of underlying disease on rejection outcomes following orthotopic liver transplantation.

    abstract::Despite major advances in immunopharmacology, virtually all patients receive the same center-specific immunosuppressive regimen following orthotopic liver transplantation (OLT). The present analysis was performed on the hypothesis that the original disease representing the indication for OLT leads to a different initi...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199602270-00007

    authors: Berlakovich GA,Imhof M,Karner-Hanusch J,Gotzinger P,Gollackner B,Gnant M,Hanelt S,Laufer G,Muhlbacher F,Steininger R

    更新日期:1996-02-27 00:00:00

  • Membranous glomerulopathy following kidney transplantation. Association with renal vein thrombosis in two of nine cases.

    abstract::The association of renal vein thrombosis and membranous glomerulopathy in native kidneys has been well documented. However, this association has only occasionally been described following renal transplantation. A review of 693 renal transplant recipients revealed 77 (11%) in whom persistent, heavy proteinuria (greater...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:

    authors: First MR,Mendoza N,Maryniak RK,Weiss MA

    更新日期:1984-12-01 00:00:00

  • The frequency of rejection episodes after combined kidney-pancreas transplant--the impact on graft survival.

    abstract::The recipients of combined kidney-pancreas transplants (SPK) are unique because they routinely receive two allografts from the same donor. In a previous study, we found that the long-term graft survival of the two allografts was different, with better graft survival seen in the pancreas allograft. In an attempt to und...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199408270-00006

    authors: Tesi RJ,Henry ML,Elkhammas EA,Davies EA,Ferguson RM

    更新日期:1994-08-27 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

  • Family Over Rules? An Ethical Analysis of Allowing Families to Overrule Donation Intentions.

    abstract::Millions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) oc...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000001536

    authors: Shaw D,Georgieva D,Haase B,Gardiner D,Lewis P,Jansen N,Wind T,Samuel U,McDonald M,Ploeg R,ELPAT Working Group on Deceased Donation.

    更新日期:2017-03-01 00:00:00

  • Selective inhibition of vascular cell adhesion molecule-1 expression by verapamil in human vascular endothelial cells.

    abstract::Up-regulated expression of adhesion molecules on vascular endothelial cells (ECs) is an initial event in leukocyte adhesion to ECs, which is a crucial step in the process of inflammatory or immune reaction leading to organ transplant rejection. Verapamil and other calcium channel blockers have been reported to improve...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199703150-00024

    authors: Yamaguchi M,Suwa H,Miyasaka M,Kumada K

    更新日期:1997-03-15 00:00:00

  • Acute nephrotoxicity of tacrolimus and sirolimus in renal isografts: differential intragraft expression of transforming growth factor-beta1 and alpha-smooth muscle actin.

    abstract:BACKGROUND:Renal dysfunction early after kidney transplantation has multiple causes including ischemia-reperfusion (I/R) injury and drug-induced nephrotoxicity. This study assesses the acute nephrotoxicity of tacrolimus (Tac) and sirolimus (Sir) in a rat renal isograft model. METHODS:Lewis renal isografts and uninephr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000128837.07640.ae

    authors: Ninova D,Covarrubias M,Rea DJ,Park WD,Grande JP,Stegall MD

    更新日期:2004-08-15 00:00:00

  • Cytomegalovirus infection and gastric emptying.

    abstract::Gastrointestinal infection due to cytomegalovirus occurs frequently in liver transplant recipients. Upper gastrointestinal cytomegalovirus infection is associated with subjective complaints of nausea, a sense of abdominal fullness, and occasionally emesis and/or dysphagia. In order to determine whether these symptoms ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199207000-00012

    authors: Van Thiel DH,Gavaler JS,Schade RR,Chien MC,Starzl TE

    更新日期:1992-07-01 00:00:00

  • Late recurrent urinary tract infections may produce renal allograft scarring even in the absence of symptoms or vesicoureteric reflux.

    abstract:BACKGROUND:The significance of late urinary tract infections (UTIs) after renal transplantation and their association with scarring and graft dysfunction remains controversial. We sought to define the prevalence of renal scarring in allograft recipients with a history of late recurrent UTIs, to determine whether the pr...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000275377.09660.fa

    authors: Dupont PJ,Psimenou E,Lord R,Buscombe JR,Hilson AJ,Sweny P

    更新日期:2007-08-15 00:00:00

  • Reconstitution of (BALB/c x B6)F1 normal mice with stem cells and thymus from nonobese diabetic mice results in autoimmune insulitis of the normal hosts' pancreases.

    abstract::The NOD mouse develops immune-mediated diabetes mellitus characterized by T cell infiltration and destruction of pancreatic islet tissue. We wished to determine whether one contributing factor was an abnormality of the NOD pancreas that caused it to elicit an attack by NOD T cells. Therefore we constructed mice that h...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199206000-00032

    authors: Stein PH,Rees MA,Singer A

    更新日期:1992-06-01 00:00:00

  • In vivo immunoadsorption of antipig antibodies in baboons using a specific Gal(alpha)1-3Gal column.

    abstract::The major role of anti-alphaGal antibodies in the hyperacute rejection of pig organs by humans and baboons has been clearly demonstrated. Spacered alpha-galactose disaccharide (Gal(alpha1)-3Gal) hapten was produced by chemical synthesis and covalently attached to a flexible, hydrophilic polymer (PAA), which in turn wa...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199611270-00001

    authors: Taniguchi S,Neethling FA,Korchagina EY,Bovin N,Ye Y,Kobayashi T,Niekrasz M,Li S,Koren E,Oriol R,Cooper DK

    更新日期:1996-11-27 00:00:00

  • Prolongation of liver allograft survival after interleukin-10 gene transduction 24-48 hours before donation.

    abstract:BACKGROUND:Interleukin- (IL) 10 may be a potent regulator for controlling of allograft rejection. A single administration of IL-10 is not effective for controlling graft rejection. Gene transfer is an attractive vehicle for prolonging the expression of short-lived proteins. METHODS:Donor or recipient livers were trans...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200007270-00018

    authors: Tashiro H,Shinozaki K,Yahata H,Hayamizu K,Okimoto T,Tanji H,Fudaba Y,Yamamoto H,Fan X,Ito H,Asahara T

    更新日期:2000-07-27 00:00:00

  • New mouse model to study islet transplantation in insulin-dependent diabetes mellitus.

    abstract:BACKGROUND:Islet transplantation studies with diabetic rodents frequently use treatment with diabetogens such as alloxan or streptozotocin to render hosts hyperglycemic. These chemicals produce unwanted toxic side effects, which complicate interpretations of damage produced by hyperglycemia versus direct toxin-induced ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200204270-00024

    authors: Mathews CE,Langley SH,Leiter EH

    更新日期:2002-04-27 00:00:00

  • Significance of true-positive and false-positive pretransplantation lymphocytotoxic crossmatch in primary liver allograft outcomes.

    abstract:BACKGROUND:At the time of transplantation, a recipient's serum is tested against the prospective donor's lymphocytes to identify specific reactivity and to look for a donor-specific crossmatch (CXM). Here, we investigated the relationship between the pretransplantation lymphocytotoxic CXM results and the long-term outc...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e31828d155a

    authors: Shin M,Moon HH,Kim JM,Park JB,Kwon CH,Kim SJ,Lee SK,Joh JW

    更新日期:2013-06-15 00:00:00

  • Long-term lung preservation with the PAF antagonist BN 52021.

    abstract::Platelet activating factor (PAF, 1-alkyl-2(R)-acetyl-glycero-3- phosphorylcholine) is a phospholipid that is released by a variety of cells. The similarity between the pathophysiological effects of PAF and posttransplant pulmonary dysfunction led to an evaluation of a PAF antagonist as an adjunct to lung preservation....

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199106000-00002

    authors: Conte JV Jr,Katz NM,Wallace RB,Foegh ML

    更新日期:1991-06-01 00:00:00

  • Kidney transplantation from small pediatric donors: does recipient body mass index matter?

    abstract:BACKGROUND:The influence of recipient body mass index (BMI) on pediatric-donor kidney transplant outcomes is unclear. We aimed to determine graft survival and functional outcomes of pediatric-donor kidneys compared with adult kidneys stratified by recipient BMI group. METHODS:Scientific Registry of Transplant Recipien...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e318241d57d

    authors: Kayler LK,Zendejas I,Gregg A,Wen X

    更新日期:2012-02-27 00:00:00

  • Immunopathological observations after xenogeneic liver perfusions using donor pigs transgenic for human decay-accelerating factor.

    abstract:BACKGROUND:Donor pigs transgenic for human decay-accelerating factor (hDAF) were used in a xenogeneic ex vivo liver perfusion model to study the effect of this modification on the development of hyperacute rejection. METHODS:Three transgenic pigs were hepatectomized after hypothermic portal and transaortal gravity per...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199708150-00002

    authors: Pascher A,Poehlein C,Storck M,Prestel R,Mueller-Hoecker J,White DJ,Abendroth D,Hammer C

    更新日期:1997-08-15 00:00:00

  • Results of renal transplantation in patients with renal cell carcinoma and von Hippel-Lindau disease.

    abstract:BACKGROUND:Patients with von Hippel-Lindau (VHL) disease are at risk for the development of end-stage renal failure from the treatment of localized renal cell carcinoma. Transplantation with its attendant immunosuppression may predispose patients to tumor recurrence; however, there is little information regarding the o...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199712270-00017

    authors: Goldfarb DA,Neumann HP,Penn I,Novick AC

    更新日期:1997-12-27 00:00:00

  • Comparison of specific radioimmunoassays for cyclosporine.

    abstract::This study compares two recently introduced radioimmunoassay kits involving specific monoclonal antibodies to cyclosporine. One kit (Sandimmun) involved 3H-labeled CsA (3H-CsA) as tracer and the other (CY-CLO-Trac-SP) involved a 125I-labeled conjugated derivative of CsA. The kits were nearly equivalent in method perfo...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198904000-00019

    authors: Sgoutas DS,Hammarstrom M

    更新日期:1989-04-01 00:00:00

  • Tacrolimus trough level at discharge predicts acute rejection in moderately sensitized renal transplant recipients.

    abstract:BACKGROUND:Goal tacrolimus concentrations for the prevention of rejection in sensitized renal transplant recipients are not well established. METHODS:We evaluated the association between discharge tacrolimus trough concentration and the incidence of biopsy-proven acute rejection (BPAR) in 216 moderately sensitized ren...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0000000000000149

    authors: Richards KR,Hager D,Muth B,Astor BC,Kaufman D,Djamali A

    更新日期:2014-05-27 00:00:00

  • Clinical determinants of multiple acute rejection episodes in kidney transplant recipients.

    abstract:BACKGROUND:Recipients with multiple (more than one) acute rejection (AR) episodes have significantly lower graft survival rates than those with no AR or only one treated episode. However, fewer than 50% of recipients treated for one AR episode will have another episode. METHODS:We studied recipients with at least one ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200006150-00024

    authors: Humar A,Payne WD,Sutherland DE,Matas AJ

    更新日期:2000-06-15 00:00:00

  • Human heart endothelial-cell-restricted allorecognition.

    abstract::We studied the reactivity of cardiac graft-infiltrating cells, cultured from endomyocardial biopsy specimens, toward heart endothelial cells (Hec). In two cases, Hec derived from the specific donor heart or Hec compatible with the donor were lysed, but not the syngeneic B cell line. A vessel-derived endothelial cell l...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199608150-00017

    authors: Jutte NH,Knoop CJ,Heijse P,Balk AH,Mochtar B,Claas FH,Weimar W

    更新日期:1996-08-15 00:00:00

  • Segmental pancreatic autotransplantation in the pig.

    abstract::The pig has been considered unsuitable for experimental pancreatic transplantation. In order to develop a model for segmental transplantation, the vascular anatomy was studied in 41 pigs. No variation in venous drainage of the pancrease was found. In contrast, 3 variations of arterial supply were noted. In 29 of the p...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198901000-00010

    authors: Shokouh-Amiri MH,Rahimi-Saber S,Andersen HO

    更新日期:1989-01-01 00:00:00

  • Is selenium deficiency an important risk factor for chronic graft nephropathy? A pilot study.

    abstract:BACKGROUND:Lipid peroxidation by free radicals is a key step in the development of atherosclerosis. Chronic graft nephropathy (CGN) is a common cause of allograft failure and shares many histologic features with atherosclerosis. Although hyperlipidemia is a common finding in renal transplant recipients, not all patient...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.TP.0000090750.47058.24

    authors: Morris-Stiff GJ,Oleesky D,Jurewicz WA

    更新日期:2003-10-15 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