Donor-Specific Anti-Human Leukocyte Antigens Antibodies, Acute Rejection, Renal Function, and Histology in Kidney Transplant Recipients Receiving Tacrolimus and Everolimus

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dc.citation.issue6
dc.citation.volume45
dc.contributor.authorFerreira, Alexandra Nicolau [UNIFESP]
dc.contributor.authorFelipe, Claudia Rosso [UNIFESP]
dc.contributor.authorCristelli, Marina Pontello [UNIFESP]
dc.contributor.authorViana, Laila [UNIFESP]
dc.contributor.authorBasso, Geovana [UNIFESP]
dc.contributor.authorStopa, Suelen[UNIFESP]
dc.contributor.authorMansur, Juliana Busato [UNIFESP]
dc.contributor.authorPaula, Mayara Ivani de [UNIFESP]
dc.contributor.authorBessa, Adrieli Barros [UNIFESP]
dc.contributor.authorRuiz, Priscila Ruppel [UNIFESP]
dc.contributor.authorAguiar, Wilson Ferreira [UNIFESP]
dc.contributor.authorCampos, Erika Fernandes [UNIFESP]
dc.contributor.authorGerbase-Lima, Maria [UNIFESP]
dc.contributor.authorProença, Henrique [UNIFESP]
dc.contributor.authorTedesco-Silva, Helio [UNIFESP]
dc.contributor.authorPestana, Jose Osmar Medina [UNIFESP]
dc.coverageBasel
dc.date.accessioned2020-07-31T12:46:32Z
dc.date.available2020-07-31T12:46:32Z
dc.date.issued2017
dc.description.abstractBackground: This analysis compared efficacy, renal function, and histology in kidney transplant recipients receiving tacrolimus (TAC) combined with everolimus (EVR) or mycophenolate (MPS). Methods: This was a retrospective analysis from a randomized trial in kidney transplant recipients who received a single 3 mg/kg dose of rabbit antithymocyte globulin (r-ATG), TAC, EVR, and prednisone (PREDen
dc.description.abstractr-ATG/EVR, n = 85), basiliximab (BAS), TAC, EVR, and PRED (BAS/EVR, n = 102) or BAS, TAC, MPS, and PRED (BAS/MPS, n = 101). We evaluated the incidence of de novo donor-specific anti-human leukocyte antigens antibodies (DSA) and histology on protocol biopsies at 12 months, and the incidence of acute rejection, estimated glomerular filtration rate (eGFR) and proteinuria at 36 months. Results: At 12 months, there were no differences in de novo DSA (6.4 vs. 3.4 vs. 5.5%) or in subclinical inflammation (2.0 vs. 4.8 vs. 10.2%), interstitial fibrosis/tubular atrophy (57.1 vs. 58.5 vs. 53.8%) and C4d deposition (2.0 vs. 7.3 vs. 2.6%). At 36 months, there were no differences in the incidence of treatment failure (19.0 vs. 27.7 vs. 27.7%, p = 0.186), first biopsy-proven acute rejection (9.5 vs. 21.8 vs. 16.8%, p = 0.073), and urine protein/creatinine ratios (0.53 +/- 1.05 vs. 0.62 +/- 0.75 vs. 0.71 +/- 1.24). eGFR was lower in the BAS/EVR compared to that in the BAS/MPS group (53.4 +/- 20.9 vs. 50.8 +/- 19.5 vs. 60.7 +/- 21.2 mL/min/1.73 m(2), p = 0.017) but comparable using a sensitive analysis (49.5 +/- 23 vs. 47.5 +/- 22.6 vs. 53.6 +/- 27.8 mL/min/1.73 m(2), p = 0.207). Conclusion: In this cohort, the use of EVR and reduced TAC concentrations were associated with comparable efficacy, renal function, and histological parameters compared to the standard-of-care immunosuppressive regimen. (C) 2017 S. Karger AG, Baselen
dc.description.affiliationUniv Fed Sao Paulo, Hosp Rim, Nephol Div, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Hosp Rim, Urol Div, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Immunol Div, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Pathol Div, Sao Paulo, Brazil
dc.description.affiliationAFIP, Immunogenet Inst, Sao Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Nephology Division
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Urology Division, Hospital do Rim
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Immunology Division
dc.description.affiliationUnifespPathology Division, Universidade Federal de São Paulo
dc.description.affiliationUnifespImmunogenetics Institute, AFIP, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipNovartis
dc.format.extent497-508
dc.identifierhttp://dx.doi.org/10.1159/000475888
dc.identifier.citationAmerican Journal Of Nephrology. Basel, v. 45, n. 6, p. 497-508, 2017.
dc.identifier.doi10.1159/000475888
dc.identifier.issn0250-8095
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56265
dc.identifier.wosWOS:000404361700006
dc.language.isoeng
dc.publisherKarger
dc.relation.ispartofAmerican Journal Of Nephrology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectRenal functionen
dc.subjectTacrolimusen
dc.subjectEverolimusen
dc.titleDonor-Specific Anti-Human Leukocyte Antigens Antibodies, Acute Rejection, Renal Function, and Histology in Kidney Transplant Recipients Receiving Tacrolimus and Everolimusen
dc.typeinfo:eu-repo/semantics/article
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