PMID- 15919468
OWN - NLM
STAT- MEDLINE
DCOM- 20050922
LR  - 20161124
IS  - 0041-1345 (Print)
IS  - 0041-1345 (Linking)
VI  - 37
IP  - 4
DP  - 2005 May
TI  - Steroid sparing in renal transplantation with tacrolimus and mycophenolate 
      mofetil: three-year results.
PG  - 1792-4
AB  - Although renal transplantation with a 7-day steroid-sparing regimen, tacrolimus 
      and mycophenolate, is associated with good short-term outcomes, late allograft 
      dysfunction and failure remain concerns. In this study 101 consecutive patients 
      underwent renal transplantation using this immunosuppressive regimen. In 
      addition, anti-CD25 monoclonal antibody was used in 25 high-risk patients 
      (regrafts, two-antigen human leukocyte antigen (HLA)-DR mismatch or sensitized 
      with anti-HLA panel reactivity >30%). After a median follow-up of 39 months 
      (range 29 to 49), overall patient survival is 98%, with two cardiac deaths. Three 
      other graft losses occurred, one each to early venous thrombosis, polyoma viral 
      nephropathy, and late rejection due to noncompliance. Therefore, overall graft 
      survival is 95%. The acute rejection rate at 6 and 12 months was 19% (no 
      rejection occurred between months 6 and 12). Late rejection was uncommon, with 
      only two further episodes beyond 12 months. Mean creatinine at 12 months was 144 
      micromol/L and mean estimated glomerular filtration rate (GFR) of 55 mL/min. 
      Graft function was stable at 3 years with a mean creatinine of 142 micromol/L and 
      mean estimated GFR 56 mL/min. During the study, five patients developed 
      posttransplant diabetes mellitus (two cases beyond 12 months). Tissue-invasive 
      cytomegalovirus disease and BK viral nephropathy each occurred in three patients, 
      with all episodes in the first 12 months. Mean weight gain is 3.3 kg and mean 
      blood pressure is 135/81 on an average of 1.5 antihypertensive agents. This 
      steroid-avoidance regimen is associated with excellent medium-term patient and 
      graft outcomes and a low incidence of side effects.
FAU - Borrows, R
AU  - Borrows R
AD  - Renal Unit, St. Mary's Hospital, Paddington, London, United Kingdom. 
      richardborrows@doctors.org.uk
FAU - Loucaidou, M
AU  - Loucaidou M
FAU - Van Tromp, J
AU  - Van Tromp J
FAU - Singh, S
AU  - Singh S
FAU - Cairns, T
AU  - Cairns T
FAU - Griffith, M
AU  - Griffith M
FAU - Hakim, N
AU  - Hakim N
FAU - McLean, A
AU  - McLean A
FAU - Palmer, A
AU  - Palmer A
FAU - Papalois, V
AU  - Papalois V
FAU - Taube, D
AU  - Taube D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Glucocorticoids)
RN  - AYI8EX34EU (Creatinine)
RN  - HU9DX48N0T (Mycophenolic Acid)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Creatinine/blood
MH  - Follow-Up Studies
MH  - Glomerular Filtration Rate
MH  - Glucocorticoids/*adverse effects
MH  - Graft Rejection/epidemiology/immunology/prevention & control
MH  - Graft Survival
MH  - Histocompatibility Testing
MH  - Humans
MH  - Kidney Transplantation/immunology/mortality/*physiology
MH  - Mycophenolic Acid/*analogs & derivatives/therapeutic use
MH  - Reoperation
MH  - Survival Analysis
MH  - Tacrolimus/*therapeutic use
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2005/05/28 09:00
MHDA- 2005/09/24 09:00
CRDT- 2005/05/28 09:00
PHST- 2005/05/28 09:00 [pubmed]
PHST- 2005/09/24 09:00 [medline]
PHST- 2005/05/28 09:00 [entrez]
AID - S0041-1345(05)00421-5 [pii]
AID - 10.1016/j.transproceed.2005.03.150 [doi]
PST - ppublish
SO  - Transplant Proc. 2005 May;37(4):1792-4. doi: 10.1016/j.transproceed.2005.03.150.