Linked Life Data

21807891

Source:http://linkedlifedata.com/resource/pubmed/id/21807891

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
2011-9-1
pubmed:abstractText
The optimal long-term regimen for immunosuppression for kidney transplant recipients is unknown. We conducted a randomized trial involving 150 kidney transplant recipients to compare tacrolimus/sirolimus, tacrolimus/mycophenolate mofetil (MMF), and cyclosporine/sirolimus. All patients received daclizumab induction and maintenance corticosteroids. Median follow-up was 8 yr post-transplant. Acute rejection (AR) occurred significantly less often among those treated with tacrolimus/MMF (12%) than among those treated with tacrolimus/sirolimus (30%) or cyclosporine/sirolimus (28%). Mean estimated GFR was consistently higher in the tacrolimus/MMF arm, especially after controlling for donor age in a multivariable model during the first 36 mo (P ? 0.008). The rate of dying with a functioning graft was significantly higher among those treated with tacrolimus/sirolimus (26%) than among those treated with tacrolimus/MMF (12%) or cyclosporine/sirolimus (4%). We did not observe significant differences in actuarial graft survival at 8 yr post-transplant between the groups. Patient noncompliance seemed responsible for 45% (13/29) of observed graft failures, with 11 of these occurring after 36 mo. Significantly more viral infections, protocol violations, and need for antilipid therapy occurred among patients receiving sirolimus, but we did not observe differences between the groups with regard to infections requiring hospitalization or new-onset diabetes. Taken together, these results suggest that maintenance therapy with tacrolimus/MMF is more favorable than either tacrolimus/sirolimus or cyclosporine/sirolimus.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
1533-3450
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
22
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1758-68
pubmed:meshHeading
pubmed-meshheading:21807891-Adolescent, pubmed-meshheading:21807891-Adult, pubmed-meshheading:21807891-Aged, pubmed-meshheading:21807891-Cyclosporine, pubmed-meshheading:21807891-Diabetes Mellitus, pubmed-meshheading:21807891-Drug Therapy, Combination, pubmed-meshheading:21807891-Dyslipidemias, pubmed-meshheading:21807891-Female, pubmed-meshheading:21807891-Florida, pubmed-meshheading:21807891-Graft Rejection, pubmed-meshheading:21807891-Guideline Adherence, pubmed-meshheading:21807891-Humans, pubmed-meshheading:21807891-Immunosuppression, pubmed-meshheading:21807891-Immunosuppressive Agents, pubmed-meshheading:21807891-Infection, pubmed-meshheading:21807891-Kidney Function Tests, pubmed-meshheading:21807891-Kidney Transplantation, pubmed-meshheading:21807891-Male, pubmed-meshheading:21807891-Middle Aged, pubmed-meshheading:21807891-Mycophenolic Acid, pubmed-meshheading:21807891-Sirolimus, pubmed-meshheading:21807891-Young Adult
pubmed:year
2011
pubmed:articleTitle
Randomized trial of immunosuppressive regimens in renal transplantation.
pubmed:affiliation
Department of Medicine, Division of Nephrology, University of Miami Miller School of Medicine, P.O. Box 012440 (R-440), Miami, FL 33101, USA. gguerra@med.miami.edu
pubmed:publicationType
Journal Article, Comparative Study, Randomized Controlled Trial