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 incidence and severity of acute rejection, similar graft survival, and better graft function over 12 months. However, the multicenter trials did not include the Asian recipients of living donor kidneys. METHODS:To assess the efficacy of MMF as the third component of a triple therapy in addition to CsA-Neoral and steroids in living donor renal transplantation recipients in Asians, a total of 100 recipients were randomized to receive CsA-Neoral and steroids (control group, n=50), or MMF-based triple therapy (1.0 g of MMF twice daily from postoperative day 2, MMF group, n=50). The dosing plan for Neoral and steroids was essentially same between groups. During 12 months of follow-up, we compared the incidence of acute rejection, adverse events such as infections, and 12-month actual graft and patient survival. RESULTS:The graft and patient survival at 1 year was excellent in both groups: 96/98% in the control group and 98/100% in the MMF group, respectively. MMF significantly reduced the proportion of patients with at least one episode of acute rejection (34% in the control group vs. 14% in the MMF group), cumulative incidence of acute rejection episodes (46% vs. 16%), and requirement of antilymphocyte antibody (21.7% vs. 12.5%). In the MMF group, viral infection such as herpes zoster or chicken pox was more prevalent than in the control group. CONCLUSIONS:Like cadaveric renal transplantation, this open clinical trial showed MMF to be effective in reducing the incidence and severity of acute rejection if used in conjunction with Neoral and steroids after living donor renal transplantation in Asian ethnicity.

journal_name

Transplantation

journal_title

Transplantation

authors

Kim YS,Moon JI,Kim SI,Park K

doi

10.1097/00007890-199908270-00023

subject

Has Abstract

pub_date

1999-08-27 00:00:00

pages

578-81

issue

4

eissn

0041-1337

issn

1534-6080

journal_volume

68

pub_type

临床试验,杂志文章,随机对照试验
  • Tacrolimus pharmacogenetics: the CYP3A5*1 allele predicts low dose-normalized tacrolimus blood concentrations in whites and South Asians.

    abstract::Previously, we demonstrated that the dose-normalized tacrolimus blood concentration after renal transplantation was associated with a single nucleotide polymorphism (SNP) in the CYP3AP1 gene, probably through linkage with an SNP in the CYP3A5 gene. Individuals with at least one CYP3A5*1 allele synthesize CYP3A5 and CY...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000151766.73249.12

    authors: Macphee IA,Fredericks S,Mohamed M,Moreton M,Carter ND,Johnston A,Goldberg L,Holt DW

    更新日期:2005-02-27 00:00:00

  • Renal transplant from very old donors: how far can we go?

    abstract:BACKGROUND:The organ shortage has led many transplant centers to accept kidneys from old, suboptimal deceased donors, and make increasing use of old-for-old allocation systems. We report the experience of an Italian transplant center in the utilization of "ultra-old" (>75 years old) donors. METHODS:Sixty grafts from d...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181a6b4ff

    authors: Collini A,Kalmar P,Dhamo A,Ruggieri G,Carmellini M

    更新日期:2009-06-27 00:00:00

  • Graft-versus-host reactions in the beige mouse. An investigation of the role of host and donor natural killer cells in the pathogenesis of graft-versus-host disease.

    abstract::To investigate the role of natural killer (NK) cells in the induction and pathogenesis of graft-versus-host (GVH) disease, +/beige (+/bg; normal NK cell activity) and beige/beige (bg/bg; deficient NK cell activity) parental C57BL/6 (B6) lymphoid cells were used to induce GVH reactions in either B6 X C3H/Hej +/bg (+/bg...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198708000-00017

    authors: Ghayur T,Seemayer TA,Kongshavn PA,Gartner JG,Lapp WS

    更新日期:1987-08-01 00:00:00

  • Cerebrovascular events in renal transplant recipients.

    abstract:BACKGROUND:The incidence of stroke and risk factors for different subtypes of cerebrovascular (CBV) events in renal transplant recipients have not been examined in any large prospective controlled trial. METHODS:The Assessment of Lescol in Renal Transplantation was a randomized, double-blind, placebo-controlled study ...

    journal_title:Transplantation

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/TP.0b013e31818bfce8

    authors: Abedini S,Holme I,Fellström B,Jardine A,Cole E,Maes B,Holdaas H,ALERT Study Group.

    更新日期:2009-01-15 00:00:00

  • Induction of kidney allograft tolerance after transient lymphohematopoietic chimerism in patients with multiple myeloma and end-stage renal disease.

    abstract:BACKGROUND:Two patients with end-stage renal disease secondary to multiple myelomas were treated with combined kidney and bone marrow transplantation in an effort to achieve donor-specific allotolerance through the induction of mixed lymphohematopoietic chimerism. METHODS:Two female patients (55 and 50 years of age) w...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200211270-00011

    authors: Bühler LH,Spitzer TR,Sykes M,Sachs DH,Delmonico FL,Tolkoff-Rubin N,Saidman SL,Sackstein R,McAfee S,Dey B,Colby C,Cosimi AB

    更新日期:2002-11-27 00:00:00

  • Plasma exchange and retransplantation in recurrent nephrosis of patients with congenital nephrotic syndrome of the Finnish type (NPHS1).

    abstract:BACKGROUND:Recurrent nephrotic syndrome (NS) is a severe problem after renal transplantation in patients with congenital nephrotic syndrome of the Finnish type (NPHS1). The NPHS1 kidneys do not express nephrin, and antibodies against this major glomerular filter protein have been observed in NPHS1 children with recurre...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000262569.27890.64

    authors: Kuusniemi AM,Qvist E,Sun Y,Patrakka J,Rönnholm K,Karikoski R,Jalanko H

    更新日期:2007-05-27 00:00:00

  • Separate clones of cytotoxic T lymphocytes are generated against private and public H-2 antigens.

    abstract::By cytolysis and monolayer absorption tests, the kinetics of the generation of CBA/H cytotoxic lymphocytes (Tc) in response to stimulation by H-2b antigens have been analyzed in vitro. The Tc population which reacts with public antigens of H-2b and H-2d strains shows peak activity in culture at 4 to 5 days, then rapi...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198006000-00012

    authors: Schnagl HY,Boyle W

    更新日期:1980-06-01 00:00:00

  • Five-year outcome in pediatric patients with mycophenolate mofetil-based renal transplantation.

    abstract:BACKGROUND:Mycophenolate mofetil (MMF) based immunosuppression after renal transplantation has proven to be safe and beneficial for children and adolescents. However, long-term analysis, in particular of pediatric patients, is scarce. PATIENTS:Data of 140 patients receiving MMF versus azathioprine (AZA) in combination...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/01.tp.0000258587.70166.87

    authors: Jungraithmayr TC,Wiesmayr S,Staskewitz A,Kirste G,Bulla M,Fehrenbach H,Dippell J,Greiner C,Griebel M,Helmchen U,Klaus G,Leichter HE,Mihatsch MJ,Michalk DV,Misselwitz J,Plank C,Tönshoff B,Weber LT,Zimmerhackl LB,Germ

    更新日期:2007-04-15 00:00:00

  • Comparison of clinicopathologic characteristics of urothelial carcinoma between patients after renal transplantation and on dialysis.

    abstract:BACKGROUND:Urothelial carcinoma (UC) is a common complication after renal replacement therapy (RRT) among Chinese end-stage renal disease (ESRD) patients. It is unclear whether there are any differences in the clinicopathologic characteristics of UC between renal transplantation (RT) and dialysis patients; such differe...

    journal_title:Transplantation

    pub_type: 杂志文章,收录出版

    doi:10.1097/TP.0000000000000112

    authors: Zhang B,Shen C,Han WK,Yu W

    更新日期:2014-09-15 00:00:00

  • Measuring compliance with drug regimens after renal transplantation: comparison of self-report and clinician rating with electronic monitoring.

    abstract::Nonadherence to immunosuppressants in renal transplant recipients is a major factor affecting graft survival, but it is difficult to detect accurately in clinical practice. Adherence was measured in 153 adult renal transplant recipients using self-report questionnaires and interview, clinician rating, and cyclosporine...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.tp.0000110412.20050.36

    authors: Butler JA,Peveler RC,Roderick P,Horne R,Mason JC

    更新日期:2004-03-15 00:00:00

  • Prevention of premature ovarian failure and osteoporosis induced by irradiation using allogeneic ovarian/bone marrow transplantation.

    abstract:BACKGROUND:Two side effects of irradiation are premature ovarian failure (POF) and osteoporosis, both of which are concerns not only clinically, for patients, but also experimentally, for animals. We examine whether bone marrow transplantation (BMT) can correct the POF induced by radiation and also address whether allo...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e3181ca86bb

    authors: Feng W,Cui Y,Zhan H,Shi M,Cui W,Guo K,Li Q,Song C,Zhang Y,Mori T,Gershwin ME,Abraham NG,Ikehara S

    更新日期:2010-02-27 00:00:00

  • Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation.

    abstract:INTRODUCTION:Patients after solid organ transplantation are at an increased risk for microbial infections. Due to therapeutic immunosuppression, the response to active immunizations may be reduced. The serological efficacy of pneumococcal and influenza vaccination was studied in heart transplant recipients. PATIENTS A...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199811270-00014

    authors: Dengler TJ,Strnad N,Bühring I,Zimmermann R,Girgsdies O,Kubler WE,Zielen S

    更新日期:1998-11-27 00:00:00

  • Heterotopic Abdominal Rat Heart Transplantation as a Model to Investigate Volume Dependency of Myocardial Remodeling.

    abstract::Heterotopic abdominal rat heart transplantation has been extensively used to investigate ischemic-reperfusion injury, immunological consequences during heart transplantations and also to study remodeling of the myocardium due to volume unloading. We provide a unique review on the latter and present a summary of the ex...

    journal_title:Transplantation

    pub_type: 杂志文章,评审

    doi:10.1097/TP.0000000000001585

    authors: Benke K,Sayour AA,Mátyás C,Ágg B,Németh BT,Oláh A,Ruppert M,Hartyánszky I,Szabolcs Z,Radovits T,Merkely B,Szabó G

    更新日期:2017-03-01 00:00:00

  • Atypical mixed lymphocyte culture. Identity between mother and child in leukemia and aplastic anemia.

    abstract::The mixed lymphocyte culture tests between one patient with acute lymphocytic leukemia and her mother and between another patient with aplastic anemia and his mother were found nonreactive, despite a one-haplotype difference for HL-A. Two crossovers in each family at the MLC locus or a specific defect in lymphocyte r...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197501000-00008

    authors: Opelz G

    更新日期:1975-01-01 00:00:00

  • Xenoantisera to allotypic specificities of HLA-A and B antigens. Serological characterization.

    abstract::By using the lysostrip and the blocking of cytotoxicity by Fab2 fragments, HLA-A and B antibodies were detected in sera from rabbits and goats immunized with human high-density lipoprotein (HDL)-associated HLA antigens isolated from sera and from cultured lymphoid cells. After appropriate absorptions, the xenoantisera...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197910000-00014

    authors: Richiardi P,Pellegrino MA,Ferrone S

    更新日期:1979-10-01 00:00:00

  • Fifty-percent partial liver transplantation in the rat.

    abstract::Reduced-size liver transplantation in the rat has been useful in the study of hepatic regeneration. We describe a modified technique for partial liver transplantation in the rat using a 50% reduced-size graft. Male Lewis rats (RT1(1)), weighing 250 to 280 g, were used as donors and recipients. The harvested donor live...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199607270-00023

    authors: Omura T,Ascher NL,Emond JC

    更新日期:1996-07-27 00:00:00

  • International Liver Transplant Society Practice Guidelines: Diagnosis and Management of Hepatopulmonary Syndrome and Portopulmonary Hypertension.

    abstract::Two distinct pulmonary vascular disorders, hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) may occur as a consequence of hepatic parenchymal or vascular abnormalities. HPS and POPH have major clinical implications for liver transplantation. A European Respiratory Society Task Force on Pulmonary-H...

    journal_title:Transplantation

    pub_type: 杂志文章,实务指引

    doi:10.1097/TP.0000000000001229

    authors: Krowka MJ,Fallon MB,Kawut SM,Fuhrmann V,Heimbach JK,Ramsay MA,Sitbon O,Sokol RJ

    更新日期:2016-07-01 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

  • Manufacture of antithymocyte globulin (ATGAM) for clinical trials.

    abstract::Methods are described for preparing large amounts of horse anti-human thymocyte globulin (ATG, ATGAM; The Upjohn Company) for clinical use. These methods have been used since 1968 to provide material for clinical trials. Characteristics of 40 lots of ATG are summarized. ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-197910000-00007

    authors: Wechter WJ,Nelson JW,Perper RJ,Parcells AJ,Riebe KW,Evans JS,Satoh PS,Ko H

    更新日期:1979-10-01 00:00:00

  • Depletion of hepatitis C virus from procured kidneys using pulsatile perfusion preservation.

    abstract::The safety of the use of kidneys procured from a hepatitis C virus (HCV)-positive cadaver donors in transplantation has recently been the subject of controversy. One factor that is important in determining the transmission of the virus and/or viral liver disease is the total viral inoculum to which the renal allograft...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-199403270-00011

    authors: Zucker K,Cirocco R,Roth D,Olson L,Burke GW,Nery J,Esquenazi V,Miller J

    更新日期:1994-03-27 00:00:00

  • Time course of glomerular endothelial injury related to pulsatile perfusion preservation.

    abstract::To elucidate the time course of glomerular and arterial endothelial injury resulting from pulsatile perfusion preservation of human kidneys, we examined two kidneys, one at 16 and the other at 42 hr, for which no suitable recipient could be found. The scanning electron microscope revealed subtle changes at 16 hr in th...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198504000-00012

    authors: Gattone VH 2nd,Filo RS,Evan AP,Leapman SB,Smith EJ,Luft FC

    更新日期:1985-04-01 00:00:00

  • Therapeutic potential of monoclonal antibodies to the leukocyte-common antigen. Synergy and interference in complement-mediated lysis.

    abstract::A series of rat monoclonal antibodies against the human leukocyte-common antigen were isolated and, by means of competitive binding assays with purified antigen, two distinct groups were defined that recognize different epitopes of the molecule. None of these antibodies were lytic with human complement, but when antib...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198511000-00013

    authors: Bindon CI,Hale G,Clark M,Waldmann H

    更新日期:1985-11-01 00:00:00

  • Low-dose mycophenolate mofetil is an effective and safe treatment to permit phased reduction in calcineurin inhibitors in chronic allograft nephropathy.

    abstract:BACKGROUND:Chronic allograft nephropathy (CAN) is the most common cause of long-term renal-allograft dysfunction and the second most common cause of transplant loss. There are concerns that prolonged patient exposure to calcineurin inhibitors (CNIs) exacerbates or promotes the process of CAN. METHODS:In our unit, we c...

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.tp.0000151145.12706.2a

    authors: Afzali B,Shah S,Chowdhury P,O'sullivan H,Taylor J,Goldsmith D

    更新日期:2005-02-15 00:00:00

  • Treatment of chronic renal allograft rejection in rats with a low-molecular-weight heparin (reviparin).

    abstract:BACKGROUND:Low-molecular-weight heparin (LMWH) has been shown to prolong survival of rat cardiac allografts independently from immunosuppressive treatment. Furthermore, long-term treatment reduces the development of chronic graft vascular disease after experimental heart transplantation. The aim of the present study wa...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-200107270-00007

    authors: Braun C,Schultz M,Fang L,Schaub M,Back WE,Herr D,Laux V,Rohmeiss P,Schnuelle P,van der Woude FJ

    更新日期:2001-07-27 00:00:00

  • Cold ischemia is a major determinant of acute rejection and renal graft survival in the modern era of immunosuppression.

    abstract:BACKGROUND:The aim of our study was to examine, in a recent cohort of kidney transplant recipients who have received modern immunosuppressive therapy, the respective role of cold ischemia time (CIT) and delayed graft function (DGF) on acute rejection (AR) rates and long-term graft survival. METHODS:We retrospectively ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/TP.0b013e318169c29e

    authors: Mikhalski D,Wissing KM,Ghisdal L,Broeders N,Touly M,Hoang AD,Loi P,Mboti F,Donckier V,Vereerstraeten P,Abramowicz D

    更新日期:2008-04-15 00:00:00

  • Langerhans cell homeostasis and turnover after nonmyeloablative and myeloablative allogeneic hematopoietic cell transplantation.

    abstract:BACKGROUND:Langerhans cells (LCs) are self-renewing epidermal myeloid cells that can migrate and mature into dendritic cells. Recipient LCs that survive cytotoxic therapy given in preparation for allogeneic hematopoietic cell transplantation may prime donor T cells to mediate cutaneous graft-versus-host disease (GVHD)....

    journal_title:Transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1097/TP.0000000000000097

    authors: Mielcarek M,Kirkorian AY,Hackman RC,Price J,Storer BE,Wood BL,Leboeuf M,Bogunovic M,Storb R,Inamoto Y,Flowers ME,Martin PJ,Collin M,Merad M

    更新日期:2014-09-15 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

  • Alterations in rat pulmonary macrophage function by the immunosuppressive agents cyclosporine, azathioprine, and prednisolone.

    abstract::Disturbances of the immune response of the lung induced by the action of immunosuppressive agents on the functional abilities of rat pulmonary alveolar macrophages (PAM) were analyzed following in vitro incubation or in vivo administration (for 30 days) of cyclosporinea, (CsA) azathioprine (Az) or prednisolone (Pr). T...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198306000-00014

    authors: Drath DB,Kahan BD

    更新日期:1983-06-01 00:00:00

  • Liver Transplantation for NASH-Related Hepatocellular Carcinoma Versus Non-NASH Etiologies of Hepatocellular Carcinoma.

    abstract:BACKGROUND:Liver transplant (LT) for nonalcoholic steatohepatitis (NASH) related hepatocellular carcinoma (HCC) is not well characterized in the literature. The aim of the study was to examine characteristics and outcomes of patients who had LT for NASH-HCC (NASH) versus HCC from other liver diseases (non-NASH). METHO...

    journal_title:Transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1097/TP.0000000000002043

    authors: Sadler EM,Mehta N,Bhat M,Ghanekar A,Greig PD,Grant DR,Yao F,Sapisochin G

    更新日期:2018-04-01 00:00:00

  • Psychological adjustment of adult bone marrow transplant donors whose recipient survives.

    abstract::The psychosocial and psychiatric impact of donating bone marrow (BM) has received little study. This mail questionnaire study of bone marrow donors whose recipient had survived more than one year post-BMT was undertaken to document the psychosocial consequences of donation on "successful" BM donors. Demographic, mood ...

    journal_title:Transplantation

    pub_type: 杂志文章

    doi:10.1097/00007890-198604000-00014

    authors: Wolcott DL,Wellisch DK,Fawzy FI,Landsverk J

    更新日期:1986-04-01 00:00:00