Planned Randomized Conversion From Tacrolimus to Sirolimus-Based Immunosuppressive Regimen in de Novo Kidney Transplant Recipients

Planned Randomized Conversion From Tacrolimus to Sirolimus-Based Immunosuppressive Regimen in de Novo Kidney Transplant Recipients

Autor Tedesco-Silva Junior, Hélio Autor UNIFESP Google Scholar
Felipe, Claudia Rosso Autor UNIFESP Google Scholar
Garcia, V. D. Google Scholar
Neto, E. D. Google Scholar
Filho, M. A. Google Scholar
Contieri, F. L. C. Google Scholar
Carvalho, D. D. B. M. de Google Scholar
Pestana, Jose Osmar Medina Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Santa Casa de Misericordia
Universidade de São Paulo (USP)
Inst Urol & Nefrol
Med Sch FAMERP HB FUNFARME
Hosp Univ Evangel Curitiba
Bonsucesso Gen Hosp
Resumo Planned conversion from tacrolimus to sirolimus was evaluated in de novo kidney transplant recipients. in this multicenter, randomized, open-label study, 297 patients were initially treated with tacrolimus, mycophenolate sodium and prednisone. of the 283 patients reaching 3 months, 97 were converted to sirolimus (SRL), 107 were maintained on tacrolimus (TAC) and 79 were patients receiving TAC without criteria to undergo intervention at month 3 (TACex). the primary objective was to show superior estimated glomerular filtration rate (eGFR) in the SRL group at month 24. of the 258 patients who completed 24 months, 91 (94%) were in the SRL group, 101 (94%) in the TAC group and 66 (84%) in the TACex group. in the intention-to-treat population there were no differences in eGFR (66.225.3 vs. 70.7 +/- 25.1, p=0.817) or in the severity of chronic sclerosing lesions scores in 24-month protocol biopsies. Higher mean urinary protein-to-creatinine ratio (0.36 +/- 0.69 vs. 0.15 +/- 0.53, p=0.03) and higher incidence of treated acute rejection between months 3-24 (13.4% vs. 4.7%, p=0.047) were observed in SRL compared to TAC group. in this population planned conversion from TAC to SRL 3 months after kidney transplantation was not associated with improved renal function at 24 months.
Assunto Conversion
kidney transplantation
sirolimus
tacrolimus
Idioma Inglês
Financiador Pfizer
Data 2013-12-01
Publicado em American Journal of Transplantation. Hoboken: Wiley-Blackwell, v. 13, n. 12, p. 3155-3163, 2013.
ISSN 1600-6135 (Sherpa/Romeo, fator de impacto)
Editor Wiley-Blackwell
Extensão 3155-3163
Fonte http://dx.doi.org/10.1111/ajt.12481
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000327235300017
URI http://repositorio.unifesp.br/handle/11600/37009

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