Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1590/2175-8239-jbn-3871 http://hdl.handle.net/11449/158105 |
Resumo: | ABSTRACTIntroduction: The progress in kidney transplantation has been evident over the years, as well as its benefits for patients.Objectives: To evaluate the 1.000 kidney transplants performed at the Botucatu Medical School University Hospital, subdividing the patients in different periods, according to the current immunosuppression, and evaluating the differences in graft and patient survival.Methods: Retrospective cohort analysis of the transplants performed between 06/17/87 to 07/31/16, totaling 1,046 transplants, subdivided into four different periods: 1) 1987 to 2000: cyclosporine with azathioprine; 2) 2001 to 2006: cyclosporine with mycophenolate; 3) 2007 to 2014: tacrolimus with antimetabolic; and 4) 2015 to 2016: tacrolimus with antimetabolic, with increased use of the combination of tacrolimus and mTOR inhibitors.Results: There was an increase in the mean age of recipients and increase in deceased donors and their age in the last two periods. There was a reduction in graft function delay, being 54.3% in the fourth period, compared to 78.8% in the first, p = 0.002. We found a reduction in acute rejection, being 6.1% in the last period compared to 36.3% in the first, p = 0.001. Urological complications and diabetes after transplantation were more frequent in the first two periods. The rates of cytomegalovirus infection were higher in the last two periods. There was an improvement in graft survival, p = 0.003. There was no difference in patient survival, p = 0.77 (Figure 2).Conclusion: There was a significant increase in the number of transplants, with evolution in graft survival, despite the worsening in the profiles of recipients and donors. |
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Repositório Institucional da UNESP |
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Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the yearsAvaliação dos 1000 transplantes renais realizados no Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB) da UNESP e a sua evolução ao longo dos anosKidney TransplantationImmunosuppressionSurvival AnalysisClinical EvolutionTransplante de RimImunossupressãoAnálise de SobrevidaEvolução ClínicaABSTRACTIntroduction: The progress in kidney transplantation has been evident over the years, as well as its benefits for patients.Objectives: To evaluate the 1.000 kidney transplants performed at the Botucatu Medical School University Hospital, subdividing the patients in different periods, according to the current immunosuppression, and evaluating the differences in graft and patient survival.Methods: Retrospective cohort analysis of the transplants performed between 06/17/87 to 07/31/16, totaling 1,046 transplants, subdivided into four different periods: 1) 1987 to 2000: cyclosporine with azathioprine; 2) 2001 to 2006: cyclosporine with mycophenolate; 3) 2007 to 2014: tacrolimus with antimetabolic; and 4) 2015 to 2016: tacrolimus with antimetabolic, with increased use of the combination of tacrolimus and mTOR inhibitors.Results: There was an increase in the mean age of recipients and increase in deceased donors and their age in the last two periods. There was a reduction in graft function delay, being 54.3% in the fourth period, compared to 78.8% in the first, p = 0.002. We found a reduction in acute rejection, being 6.1% in the last period compared to 36.3% in the first, p = 0.001. Urological complications and diabetes after transplantation were more frequent in the first two periods. The rates of cytomegalovirus infection were higher in the last two periods. There was an improvement in graft survival, p = 0.003. There was no difference in patient survival, p = 0.77 (Figure 2).Conclusion: There was a significant increase in the number of transplants, with evolution in graft survival, despite the worsening in the profiles of recipients and donors.RESUMOIntrodução: O progresso no transplante renal tem sido evidente ao longo dos anos, assim como seus benefícios para os pacientes.Objetivos: Avaliar os 1000 transplantes renais realizados no Hospital das Clínicas da Faculdade de Medicina de Botucatu, subdividindo os pacientes em diferentes períodos, de acordo com a imunossupressão vigente, e avaliar as diferenças em relação à sobrevida do enxerto e do paciente.Métodos: Análise da coorte retrospectiva dos transplantes realizados entre 17/06/87 a 31/07/16, totalizando 1046 transplantes, subdivididos em quatro diferentes períodos: 1) 1987 a 2000: ciclosporina com azatioprina; 2) 2001 a 2006: ciclosporina com micofenolato; 3) 2007 a 2014: tacrolimo com antimetabólico; e 4) 2015 a 2016: tacrolimo com antimetabólico, com aumento do uso da combinação de tacrolimo com inibidores da mTOR.Resultados: Houve aumento da idade média dos receptores e aumento de doadores falecidos e da idade destes nos dois últimos períodos. Observou-se redução de retardo de função do enxerto, sendo de 54,3% no quarto período, em comparação a 78,8% no primeiro, p = 0,002. Observamos redução de rejeição aguda, sendo 6,1% no último período em comparação a 36,3% no primeiro, p = 0,001. As complicações urológicas e o diabetes após o transplante foram mais frequentes nos primeiros dois períodos. As taxas de infecção por citomegalovírus foram maiores nos dois últimos períodos. Houve melhoria na sobrevida do enxerto, p = 0,003. Não houve diferença na sobrevida do paciente, p = 0,77 (Figura 2).Conclusão: Houve aumento significativo no número de transplantes, com evolução na sobrevida do enxerto, apesar da piora no perfil dos receptores e doadores.Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Clínica MédicaUniversidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Clínica MédicaSociedade Brasileira de NefrologiaUniversidade Estadual Paulista (Unesp)Nga, Hong SiAndrade, Luis Gustavo ModelliContti, Mariana MoraesValiatti, Mariana FarinaSilva, Maryanne Machado DaTakase, Henrique Mochida2018-11-12T17:28:20Z2018-11-12T17:28:20Z2018-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article162-169application/pdfhttp://dx.doi.org/10.1590/2175-8239-jbn-3871Brazilian Journal of Nephrology. Sociedade Brasileira de Nefrologia, v. 40, n. 2, p. 162-169, 2018.0101-2800http://hdl.handle.net/11449/15810510.1590/2175-8239-jbn-3871S0101-28002018000200162S0101-28002018000200162.pdfSciELOreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengBrazilian Journal of Nephrologyinfo:eu-repo/semantics/openAccess2023-12-17T06:16:12Zoai:repositorio.unesp.br:11449/158105Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462023-12-17T06:16:12Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years Avaliação dos 1000 transplantes renais realizados no Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB) da UNESP e a sua evolução ao longo dos anos |
title |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years |
spellingShingle |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years Nga, Hong Si Kidney Transplantation Immunosuppression Survival Analysis Clinical Evolution Transplante de Rim Imunossupressão Análise de Sobrevida Evolução Clínica |
title_short |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years |
title_full |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years |
title_fullStr |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years |
title_full_unstemmed |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years |
title_sort |
Evaluation of the 1000 renal transplants carried out at the University Hospital of the Botucatu Medical School (HCFMB) - UNESP and their evolution over the years |
author |
Nga, Hong Si |
author_facet |
Nga, Hong Si Andrade, Luis Gustavo Modelli Contti, Mariana Moraes Valiatti, Mariana Farina Silva, Maryanne Machado Da Takase, Henrique Mochida |
author_role |
author |
author2 |
Andrade, Luis Gustavo Modelli Contti, Mariana Moraes Valiatti, Mariana Farina Silva, Maryanne Machado Da Takase, Henrique Mochida |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Nga, Hong Si Andrade, Luis Gustavo Modelli Contti, Mariana Moraes Valiatti, Mariana Farina Silva, Maryanne Machado Da Takase, Henrique Mochida |
dc.subject.por.fl_str_mv |
Kidney Transplantation Immunosuppression Survival Analysis Clinical Evolution Transplante de Rim Imunossupressão Análise de Sobrevida Evolução Clínica |
topic |
Kidney Transplantation Immunosuppression Survival Analysis Clinical Evolution Transplante de Rim Imunossupressão Análise de Sobrevida Evolução Clínica |
description |
ABSTRACTIntroduction: The progress in kidney transplantation has been evident over the years, as well as its benefits for patients.Objectives: To evaluate the 1.000 kidney transplants performed at the Botucatu Medical School University Hospital, subdividing the patients in different periods, according to the current immunosuppression, and evaluating the differences in graft and patient survival.Methods: Retrospective cohort analysis of the transplants performed between 06/17/87 to 07/31/16, totaling 1,046 transplants, subdivided into four different periods: 1) 1987 to 2000: cyclosporine with azathioprine; 2) 2001 to 2006: cyclosporine with mycophenolate; 3) 2007 to 2014: tacrolimus with antimetabolic; and 4) 2015 to 2016: tacrolimus with antimetabolic, with increased use of the combination of tacrolimus and mTOR inhibitors.Results: There was an increase in the mean age of recipients and increase in deceased donors and their age in the last two periods. There was a reduction in graft function delay, being 54.3% in the fourth period, compared to 78.8% in the first, p = 0.002. We found a reduction in acute rejection, being 6.1% in the last period compared to 36.3% in the first, p = 0.001. Urological complications and diabetes after transplantation were more frequent in the first two periods. The rates of cytomegalovirus infection were higher in the last two periods. There was an improvement in graft survival, p = 0.003. There was no difference in patient survival, p = 0.77 (Figure 2).Conclusion: There was a significant increase in the number of transplants, with evolution in graft survival, despite the worsening in the profiles of recipients and donors. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-11-12T17:28:20Z 2018-11-12T17:28:20Z 2018-06-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/2175-8239-jbn-3871 Brazilian Journal of Nephrology. Sociedade Brasileira de Nefrologia, v. 40, n. 2, p. 162-169, 2018. 0101-2800 http://hdl.handle.net/11449/158105 10.1590/2175-8239-jbn-3871 S0101-28002018000200162 S0101-28002018000200162.pdf |
url |
http://dx.doi.org/10.1590/2175-8239-jbn-3871 http://hdl.handle.net/11449/158105 |
identifier_str_mv |
Brazilian Journal of Nephrology. Sociedade Brasileira de Nefrologia, v. 40, n. 2, p. 162-169, 2018. 0101-2800 10.1590/2175-8239-jbn-3871 S0101-28002018000200162 S0101-28002018000200162.pdf |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Brazilian Journal of Nephrology |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
162-169 application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
dc.source.none.fl_str_mv |
SciELO reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
|
_version_ |
1799965311985778688 |