Preservation of graft function in low-risk living kidney transplant recipients treated with a combination of sirolimus and cyclosporine

Preservation of graft function in low-risk living kidney transplant recipients treated with a combination of sirolimus and cyclosporine

Autor Machado, Paula Goulart Pinheiro Autor UNIFESP Google Scholar
Felipe, Claudia Rosso Autor UNIFESP Google Scholar
Park, Sung In Autor UNIFESP Google Scholar
Garcia, Riberto Autor UNIFESP Google Scholar
Moreira, Silvia Regina Silva Autor UNIFESP Google Scholar
Casarini, Dulce Elena Autor UNIFESP Google Scholar
Franco, Marcello Fabiano de Autor UNIFESP Google Scholar
Alfieri, F. Google Scholar
Tedesco-Silva Junior, Hélio Autor UNIFESP Google Scholar
Pestana, Jose Osmar Medina Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Laboratórios Wyeth-Ayerst do Brasil
Resumo The use of sirolimus (SRL) in combination with full doses of cyclosporin A (CsA) results in reduced one-year kidney allograft function, which is associated with shorter long-term allograft survival. We determined the effect of reduced CsA exposure on graft function in patients receiving SRL and prednisone. Ninety recipients of living kidney transplants receiving SRL (2 mg/day, po) were compared to 35 recipients receiving azathioprine (AZA, 2 mg kg-1 day-1, po). All patients also received CsA (8-10 mg kg-1 day-1, po) and prednisone (0.5 mg kg-1 day-1). Efficacy end-point was a composite of biopsy-confirmed acute rejection, graft loss, or death at one year. Graft function was measured by creatinine, creatinine clearance, and graft function deterioration between 3 and 12 months (delta1/Cr). CsA concentrations in patients receiving SRL were 26% lower. No differences in one-year composite efficacy end-point were observed comparing SRL and AZA groups (18 vs 20%) or in the incidence of biopsy-proven acute rejection (14.4 and 14.3%). There were no differences in mean ± SD creatinine (1.65 ± 0.46 vs 1.60 ± 0.43 mg/dl, P = 0.48) or calculated creatinine clearances (61 ± 15 vs 62 ± 13 ml/min, P = 0.58) at one year. Mean ± SD delta1/Cr (-11 ± 17 vs -14 ± 15%, P = 0.7) or the percentage of patients with >20% (26 vs 31%, P = 0.6) or >30% delta1/Cr (19 vs 17%, P = 1) did not differ between the two groups. The use of 2-mg fixed oral doses of SRL and reduced CsA exposure was effective in preventing acute rejection and preserving allograft function.
Assunto Sirolimus
Cyclosporine
Graft function
Immunosuppression
Kidney transplantation
Idioma Inglês
Data 2004-09-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 37, n. 9, p. 1303-1312, 2004.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Editor Associação Brasileira de Divulgação Científica
Extensão 1303-1312
Fonte http://dx.doi.org/10.1590/S0100-879X2004000900004
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000223707100004
SciELO S0100-879X2004000900004 (estatísticas na SciELO)
URI http://repositorio.unifesp.br/handle/11600/2206

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