PMID- 12095048
OWN - NLM
STAT- MEDLINE
DCOM- 20021223
LR  - 20230124
IS  - 1600-6135 (Print)
IS  - 1600-6135 (Linking)
VI  - 2
IP  - 1
DP  - 2002 Jan
TI  - Cyclosporine microemulsion and tacrolimus are associated with decreased chronic 
      allograft failure and improved long-term graft survival as compared with 
      sandimmune.
PG  - 100-4
AB  - Tacrolimus and cyclosporine in the microemulsion formulation Neoral have 
      demonstrated improvements in acute rejection rates after renal transplantation 
      compared with conventional cyclosporine formulation, Sandimmune. To evaluate 
      whether these drugs are also associated with improvements in chronic allograft 
      failure (CAF) rates, we retrospectively analyzed 32,040 primary renal allograft 
      recipients reported to the United States Renal Data System (USRDS) between 1994 
      and 1997. Graft loss secondary to CAF was defined as graft loss beyond 6 months 
      post-transplant, censored for death, acute rejection, thrombosis, infections and 
      noncompliance. A Cox proportional hazard model was used to investigate the 
      relationship between graft loss secondary to CAF and the use of conventional 
      cyclosporine formulation, as opposed to cyclosporine microemulsion and tacrolimus 
      (Prograf). The analysis was corrected for confounding variables, such as acute 
      rejection, sex, race, human leukocyte antigen (HLA) mismatch, % panel reactive 
      antibodies (PRA), delayed graft function (DGF), cold ischemia time, induction 
      therapy, dialysis time, etiology of end-stage renal disease, cytomegalovirus 
      (CMV) risk group, donor source, era effect, and mycophenolate mofetil (MMF) use. 
      Cyclosporine microemulsion use was associated with a significantly lower relative 
      risk (RR = 0.6, Cl = 0.5-0.7) for CAF as opposed to conventional cyclosporine 
      formulation. Likewise tacrolimus as compared with conventional cyclosporine 
      formulation was associated with a significantly lower relative risk (RR = 0.7, CI 
      = 0.6-0.8) for CAF. Conventional cyclosporine formulation treatment was 
      associated with a 87.6% adjusted CAF-free survival rate at 4 years. Both 
      tacrolimus and cyclosporine microemulsion were associated with a significantly 
      better adjusted CAF-free survival at 4years (91.4 and 92.4%, respectively). Both 
      cyclosporine microemulsion and tacrolimus are associated with improved graft 
      survival and a decreased relative risk for CAF when compared with the older 
      conventional cyclosporine formulation. This association is independent of the use 
      of MMF or changes in era.
FAU - Meier-Kriesche, Herwig-Ulf
AU  - Meier-Kriesche HU
AD  - University of Michigan Health System, Department of Internal Medicine, 
      Nephrology, Ann Arbor 48109-0364, USA.
FAU - Kaplan, Bruce
AU  - Kaplan B
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am J Transplant
JT  - American journal of transplantation : official journal of the American Society of 
      Transplantation and the American Society of Transplant Surgeons
JID - 100968638
RN  - 0 (Emulsions)
RN  - 0 (Immunosuppressive Agents)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Chemistry, Pharmaceutical
MH  - Cyclosporine/administration & dosage/*therapeutic use
MH  - Emulsions
MH  - Female
MH  - Graft Survival/drug effects/*physiology
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Kidney Transplantation/*immunology/mortality/physiology
MH  - Male
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Tacrolimus/administration & dosage/*therapeutic use
MH  - Time Factors
MH  - Transplantation, Homologous
MH  - Treatment Failure
EDAT- 2002/07/04 10:00
MHDA- 2002/12/27 04:00
CRDT- 2002/07/04 10:00
PHST- 2002/07/04 10:00 [pubmed]
PHST- 2002/12/27 04:00 [medline]
PHST- 2002/07/04 10:00 [entrez]
AID - S1600-6135(22)07061-7 [pii]
AID - 10.1034/j.1600-6143.2002.020116.x [doi]
PST - ppublish
SO  - Am J Transplant. 2002 Jan;2(1):100-4. doi: 10.1034/j.1600-6143.2002.020116.x.