PMID- 19202447
OWN - NLM
STAT- MEDLINE
DCOM- 20090311
LR  - 20131121
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 87
IP  - 3
DP  - 2009 Feb 15
TI  - A prospective trial of a steroid-free/calcineurin inhibitor minimization regimen 
      in human leukocyte antigen (HLA)-identical live donor renal transplantation.
PG  - 408-14
LID - 10.1097/TP.0b013e318194515c [doi]
AB  - BACKGROUND: Few prospective trials in human leukocyte antigen (HLA) identical 
      living donor (LD) renal transplantation exist. This prospective study evaluated a 
      corticosteroid (CS)-free, calcineurin inhibitor (CNI) minimization 
      immunosuppressive regimen in HLA-identical LD renal transplant recipients. 
      METHODS: Twenty HLA-identical LD recipients were prospectively enrolled. 
      Immunosuppression included mycophenolate mofetil (MMF) (2 g/day), tacrolimus 
      (target trough 4-8 ng/mL), sirolimus (target trough 6-10 ng/mL), and no pre- or 
      postoperative steroids. In the absence of prior rejection, tacrolimus was 
      discontinued at posttransplant day 120 and sirolimus at 1 year, leaving patients 
      on MMF monotherapy. RESULTS: Tacrolimus was successfully withdrawn in 94% of 
      patients (16/17). One hundred percent (15/15) of patients who reached 1-year 
      posttransplant had sirolimus discontinued. Ninety-four percent (17/18) of 
      patients remain off CSs. Mean serum creatinine at 6, 12, and 24 months were 
      1.38+/-0.32, 1.35+/-0.37, and 1.25+/-0.29 mg/dL; corresponding mean calculated 
      creatinine clearance estimates were 70+/-18, 73+/-17, and 72+/-15 mL/min. Acute 
      cellular rejection, chronic allograft nephropathy, and CNI toxicity were not 
      observed. Death-censored graft survival was 100% at last follow-up. CONCLUSIONS: 
      A CS-free, CNI minimization immunosuppressive regimen with weaning to MMF 
      monotherapy provides excellent renal function, graft survival, and patient 
      survival in HLA-identical LD renal transplant recipients.
FAU - Walker, Jennifer K
AU  - Walker JK
AD  - Department of Surgery, Division of Transplantation, University of Cincinnati, 
      Cincinnati, OH 45267-0585, USA.
FAU - Alloway, Rita R
AU  - Alloway RR
FAU - Roy-Chaudhury, Prabir
AU  - Roy-Chaudhury P
FAU - Mogilishetty, Gautham
AU  - Mogilishetty G
FAU - Cardi, Michael A
AU  - Cardi MA
FAU - Weimert, Nicole A
AU  - Weimert NA
FAU - Rike, Adele H
AU  - Rike AH
FAU - First, M Roy
AU  - First MR
FAU - Woodle, E Steve
AU  - Woodle ES
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Lipoproteins, HDL)
RN  - 0 (Lipoproteins, LDL)
RN  - 0 (Triglycerides)
RN  - 97C5T2UQ7J (Cholesterol)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adrenal Cortex Hormones
MH  - Blood Pressure
MH  - Cholesterol/blood
MH  - Creatinine/blood/metabolism
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Follow-Up Studies
MH  - Graft Rejection/epidemiology
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kidney Transplantation/*immunology/physiology
MH  - Lipoproteins, HDL/blood
MH  - Lipoproteins, LDL/blood
MH  - *Living Donors
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Time Factors
MH  - Triglycerides/blood
EDAT- 2009/02/10 09:00
MHDA- 2009/03/12 09:00
CRDT- 2009/02/10 09:00
PHST- 2009/02/10 09:00 [entrez]
PHST- 2009/02/10 09:00 [pubmed]
PHST- 2009/03/12 09:00 [medline]
AID - 00007890-200902150-00016 [pii]
AID - 10.1097/TP.0b013e318194515c [doi]
PST - ppublish
SO  - Transplantation. 2009 Feb 15;87(3):408-14. doi: 10.1097/TP.0b013e318194515c.