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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
1996-11-25
pubmed:abstractText
Financial circumstances force some stable renal transplant recipients to discontinue cyclosporine (CsA). Previous results from our center document a subgroup of these patients at increased risk for acute rejection and allograft loss, namely, those of African ancestry. After 1988, such disadvantaged recipients have been able to receive CsA at no charge through the National Organization for Rare Disorders (NORD). At the University of Alabama at Birmingham, 54 patients were enrolled in the NORD program between 1988 and 1994. Acute rejection, allograft survival, and patient survival in these patients were compared with those in 42 patients who, prior to 1988, were withdrawn from CsA for financial reasons. Both groups were similar socioeconomically. The mean follow-up was 69 +/- 33 months (+/-SD) in the withdrawal group and 45 +/- 14 months in those entering the NORD program. Acute rejections occurred with similar frequency in both groups before CsA withdrawal (45%) or NORD enrollment (48%). In contrast, acute rejections were more common in patients after the onset of CsA withdrawal (38%) than after NORD enrollment (11%) (P < 0.01). Black patients withdrawn from CsA experienced more acute rejections than their counterparts in the NORD program (57% v 15%) (P < 0.01). White NORD recipients also experienced fewer acute rejections, although the difference was not statistically significant (withdrawal group 16% v NORD group 4%; P = 0.29). Rejection episodes were accompanied by reduced graft survival in black patients withdrawn from CsA, while significant improvement was seen in those remaining on CsA-based therapy (P < 0.05). No difference in allograft survival was seen among white patients in either group (withdrawal group 74% v NORD group 82%; P = 0.33). Thus, long-term access to CsA through the NORD program reduced acute rejections and improved allograft survival in an economically disadvantaged subgroup of renal transplant recipients. These findings emphasize the importance of continued access to CsA in black renal transplant recipients and its influence on long-term allograft survival.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0272-6386
pubmed:author
pubmed:issnType
Print
pubmed:volume
28
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
572-7
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed:year
1996
pubmed:articleTitle
Benefits of continued cyclosporine through an indigent drug program.
pubmed:affiliation
Department of Medicine, University of Alabama at Birmingham, 35294-0007, USA.
pubmed:publicationType
Journal Article