PMID- 24491040
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140224
LR  - 20240506
IS  - 2047-1440 (Print)
IS  - 2047-1440 (Electronic)
IS  - 2047-1440 (Linking)
VI  - 3
IP  - 1
DP  - 2014 Feb 3
TI  - Long-term mycophenolate monotherapy in human leukocyte antigen (HLA)-identical 
      living-donor kidney transplantation.
PG  - 4
LID - 10.1186/2047-1440-3-4 [doi]
AB  - Although recipients of a first HLA-identical living-donor kidney transplant seem 
      to need less immunosuppression, there are no guideline recommendations for these 
      patients, and few prospective trials are available. METHODS: We analyzed all 
      PRA-negative patients who received a first kidney transplant from an 
      HLA-identical living donor. The patients received no antibody induction. An 
      intraoperative bolus of 500 mg of methylprednisolone was administered. Then, 
      steroid therapy was withdrawn within one week. Tacrolimus and mycophenolate 
      treatment were started 3 days before transplantation with tacrolimus target 
      levels of 4 to 8 ng/mL. In the absence of rejection, tacrolimus was withdrawn 
      between 3 and 12 months post-transplant to reach mycophenolate mofetil 
      monotherapy of 2 g/day or equivalent. RESULTS: Six patients were treated with the 
      above protocol. At last follow-up, graft and patient survival were 100%. MDRD 
      glomerular filtration rates were 54, 60, and 62 mL/min at 3 months, 12 months and 
      last follow-up, respectively. None of the patients developed PRA post-transplant. 
      One episode of acute rejection Banff IA occurred 9 years after transplantation 
      due to non-adherence with good outcome after treatment. The mean number of 
      concomitant drugs given with mycophenolate was 2.6. Four patients needed 
      antihypertensive drugs. CONCLUSION: Steroid-free de novo treatment and 
      calcineurin-inhibitor weaning with mycophenolate monotherapy is feasible in first 
      HLA-identical kidney transplantation from a living sibling.
FAU - Gasco, Blanca
AU  - Gasco B
FAU - Revuelta, Ignacio
AU  - Revuelta I
FAU - Sanchez-Escuredo, Ana
AU  - Sanchez-Escuredo A
FAU - Blasco, Miquel
AU  - Blasco M
FAU - Cofan, Federico
AU  - Cofan F
FAU - Esforzado, Nuria
AU  - Esforzado N
FAU - Quintana, Luis F
AU  - Quintana LF
FAU - Ricart, Maria Jose
AU  - Ricart MJ
FAU - Torregrosa, Jose Vicente
AU  - Torregrosa JV
FAU - Campistol, Josep M
AU  - Campistol JM
FAU - Oppenheimer, Federico
AU  - Oppenheimer F
FAU - Diekmann, Fritz
AU  - Diekmann F
AD  - Servicio de Nefrologia y Trasplante Renal, Hospital Clinic, Villarroel 170 08036 
      Barcelona, Spain. fdiekman@clinic.ub.es.
LA  - eng
PT  - Journal Article
DEP - 20140203
PL  - England
TA  - Transplant Res
JT  - Transplantation research
JID - 101597592
PMC - PMC3943084
EDAT- 2014/02/05 06:00
MHDA- 2014/02/05 06:01
PMCR- 2014/02/03
CRDT- 2014/02/05 06:00
PHST- 2013/09/18 00:00 [received]
PHST- 2014/01/07 00:00 [accepted]
PHST- 2014/02/05 06:00 [entrez]
PHST- 2014/02/05 06:00 [pubmed]
PHST- 2014/02/05 06:01 [medline]
PHST- 2014/02/03 00:00 [pmc-release]
AID - 2047-1440-3-4 [pii]
AID - 10.1186/2047-1440-3-4 [doi]
PST - epublish
SO  - Transplant Res. 2014 Feb 3;3(1):4. doi: 10.1186/2047-1440-3-4.