Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function

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dc.contributor.author Silva, Laercio A. [UNIFESP]
dc.contributor.author Felipe, Claudia Rosso [UNIFESP]
dc.contributor.author Park, Sung In [UNIFESP]
dc.contributor.author Machado, Paula Goulart Pinheiro [UNIFESP]
dc.contributor.author Garcia, Riberto [UNIFESP]
dc.contributor.author Franco, Marcello Fabiano de [UNIFESP]
dc.contributor.author Moreira, Silvia Regina Silva [UNIFESP]
dc.contributor.author Tedesco-Silva Junior, Hélio [UNIFESP]
dc.contributor.author Pestana, Jose Osmar Medina [UNIFESP]
dc.date.accessioned 2015-06-14T13:31:55Z
dc.date.available 2015-06-14T13:31:55Z
dc.date.issued 2006-01-01
dc.identifier http://dx.doi.org/10.1590/S0100-879X2006000100005
dc.identifier.citation Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 39, n. 1, p. 43-52, 2006.
dc.identifier.issn 0100-879X
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/2877
dc.description.abstract We conducted a retrospective analysis of the influence of full doses of calcineurin inhibitors [8-10 mg kg-1 day-1 cyclosporine (N = 80), or 0.2-0.3 mg kg-1 day-1 tacrolimus (N = 68)] administered from day 1 after transplantation on the transplant outcomes of a high-risk population. Induction therapy was used in 13% of the patients. Patients also received azathioprine (2 mg kg-1 day-1, N = 58) or mycophenolate mofetil (2 g/day, N = 90), and prednisone (0.5 mg kg-1 day-1, N = 148). Mean time on dialysis was 79 ± 41 months, 12% of the cases were re-transplants, and 21% had panel reactive antibodies >10%. In 43% of donors the cause of death was cerebrovascular disease and 27% showed creatinine above 1.5 mg/dL. The incidence of slow graft function (SGF) and delayed graft function (DGF) was 15 and 60%, respectively. Mean time to last dialysis and to nadir creatinine were 18 ± 15 and 34 ± 20 days, respectively. Mean creatinine at 1 year after transplantation was 1.48 ± 0.50 mg/dL (DGF 1.68 ± 0.65 vs SGF 1.67 ± 0.66 vs immediate graft function (IGF) 1.41 ± 0.40 mg/dL, P = 0.089). The incidence of biopsy-confirmed acute rejection was 22% (DGF 31%, SGF 10%, IGF 8%). One-year patient and graft survival was 92.6 and 78.4%, respectively. The incidence of cytomegalovirus disease, post-transplant diabetes mellitus and malignancies was 28, 8.1, and 0%, respectively. Compared to previous studies, the use of initial full doses of calcineurin inhibitors without antibody induction in patients with SGF or DGF had no negative impact on patient and graft survival. en
dc.format.extent 43-52
dc.language.iso eng
dc.publisher Associação Brasileira de Divulgação Científica
dc.relation.ispartof Brazilian Journal of Medical and Biological Research
dc.rights Acesso aberto
dc.subject Cyclosporine en
dc.subject Tacrolimus en
dc.subject Delayed graft function en
dc.subject Graft function en
dc.subject Kidney transplantation en
dc.title Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function en
dc.type Artigo
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.description.affiliation Universidade Federal de São Paulo (UNIFESP) Departamento de Patologia Hospital do Rim e Hipertensão
dc.description.affiliationUnifesp UNIFESP, Depto. de Patologia Hospital do Rim e Hipertensão
dc.identifier.file S0100-879X2006000100005.pdf
dc.identifier.scielo S0100-879X2006000100005
dc.identifier.doi 10.1590/S0100-879X2006000100005
dc.description.source SciELO
dc.identifier.wos WOS:000235089500005



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