Source:http://linkedlifedata.com/resource/pubmed/id/16426329
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
2
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pubmed:dateCreated |
2006-1-23
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pubmed:abstractText |
Thrombotic microangiopathy (TMA) and hemolytic uremic syndrome (HUS) represent serious threats to kidney allograft recipients. During a 4-year period, among 850 kidney transplantations, seven recipients with primary HUS and seven recipients (eight transplants) with previous or de novo TMA/HUS were identified and given calcineurin inhibitor (CNI)-free immunosuppression by sirolimus (SRL), mycophenolate mofetil and steroids. Thirteen out of 15 transplantations were successful in the long term; resulting in a mean creatinine of 101 mumol/L (16.4 months follow-up). In patients maintained on CNI-free regimen, no TMA/HUS recurrences were observed. A high rate of acute rejections (53%) may indicate insufficient immunosuppressive power and/or a causative relationship between TMA/HUS and rejection. Wound-related complications were abundant (60%), and call for surgical/immunosuppressive countermeasures. Our experience supports the idea that CNI's are major offenders in TMA/HUS induction. Total CNI elimination seems essential, as the nephrotoxic combination CNI + SRL may promote TMA. Features of TMA/HUS should be carefully explored in recurrent 'high responders'.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Feb
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pubmed:issn |
1600-6135
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
6
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
412-8
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pubmed:dateRevised |
2008-11-21
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pubmed:meshHeading |
pubmed-meshheading:16426329-Adult,
pubmed-meshheading:16426329-Cadaver,
pubmed-meshheading:16426329-Calcineurin,
pubmed-meshheading:16426329-Female,
pubmed-meshheading:16426329-Hemolytic-Uremic Syndrome,
pubmed-meshheading:16426329-Humans,
pubmed-meshheading:16426329-Immunosuppression,
pubmed-meshheading:16426329-Kidney Transplantation,
pubmed-meshheading:16426329-Living Donors,
pubmed-meshheading:16426329-Male,
pubmed-meshheading:16426329-Middle Aged,
pubmed-meshheading:16426329-Peripheral Vascular Diseases,
pubmed-meshheading:16426329-Renal Circulation,
pubmed-meshheading:16426329-Retrospective Studies,
pubmed-meshheading:16426329-Tissue Donors
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pubmed:year |
2006
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pubmed:articleTitle |
Calcineurin inhibitor-free immunosuppression in renal allograft recipients with thrombotic microangiopathy/hemolytic uremic syndrome.
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pubmed:affiliation |
Surgical Department, Transplant Section, The Rikhospitalet University Hospital, 0027 Oslo, Norway. ole.oyen@rikhospitalet.no
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pubmed:publicationType |
Journal Article,
Comparative Study
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