Concentration-controlled use of sirolimus associated with reduced exposure of cyclosporine in black recipients of primarily living renal allograft donors: 12-month results

Concentration-controlled use of sirolimus associated with reduced exposure of cyclosporine in black recipients of primarily living renal allograft donors: 12-month results

Autor Ferreira, A. N. Google Scholar
Machado, P. G. Google Scholar
Felipe, C. R. Google Scholar
Motegi, S. A. Google Scholar
Hosaka, B. H. Google Scholar
Tanaka, M. K. Google Scholar
Kamura, L. A. Google Scholar
Park, S. I. Google Scholar
Garcia, R. Google Scholar
Franco, M. Google Scholar
Alfieri, F. Google Scholar
Casarini, D. E. Google Scholar
Tedesco-Silva, H. Google Scholar
Medina-Pestana, J. O. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Labs Wyeth Whitehall
Resumo Aim: This study was designed to identify optimal therapeutic sirolimus (SRL) concentrations in black kidney transplant recipients on reduced cyclosporine (CsA) exposure and prednisone.Methods: Seventy patients (64 living/six deceased) received CsA (8-10 mg/kg/d), prednisone, and 15 mg loading dose followed by 5-mg fixed doses of SRL till day 7 when they were randomized to maintain SRL trough concentrations (high-performance liquid chromatography) of 8-12 (GI = 34) or 15-20 (GII = 36) ng/mL.Results: Mean CsA concentrations were 109 +/- 53 vs. 89 +/- 41 ng/mL and 75 +/- 54 vs. 60 +/- 35 ng/mL (ns) at 2 and 6 months. Accordingly, mean SRL trough concentrations were 12.4 +/- 6.1 vs. 20.0 +/- 9.5 ng/mL (p < 0.001) and 10.8 +/- 5.8 vs. 18.0 +/- 6.1 ng/mL (p < 0.001). the incidence of biopsy-proven acute rejection [13% (GI: 18% vs. GII: 8%, ns)], graft loss or death was 16% (GI: 21% vs. GII: 11%, ns]. There were no deaths and three graft losses (GI = 1; GII = 2). Creatinine clearance was higher in GI (64.5 +/- 17 vs. 54.4 +/- 14.7 mL/min, p = 0.011). the incidence of post-transplant diabetes mellitus was 13% and no CMV disease was observed.Conclusion: in black recipients of primarily living renal allograft donors reduced CsA exposure and SRL concentration-controlled regimens produced low incidences of acute rejection, post-transplant diabetes mellitus and CMV disease, with no significant impairment in graft function.
Palavra-chave black patients
cyclosporine
immunosuppression
kidney transplantation
sirolimus
Idioma Inglês
Data de publicação 2005-10-01
Publicado em Clinical Transplantation. Oxford: Blackwell Publishing, v. 19, n. 5, p. 607-615, 2005.
ISSN 0902-0063 (Sherpa/Romeo, fator de impacto)
Publicador Blackwell Publishing
Extensão 607-615
Fonte http://dx.doi.org/10.1111/j.1399-0012.2005.00331.x
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000231678900006
Endereço permanente http://repositorio.unifesp.br/handle/11600/28501

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