Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years

Detalhes bibliográficos
Autor(a) principal: Mota, A
Data de Publicação: 2004
Outros Autores: Arias, M, Taskinen, EI, Paavonen, T, Brault, Y, Legendre, C
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.4/195
Resumo: Graft function and histology are predictive of renal transplant survival. The Rapamune Maintenance Regimen study demonstrated that early cyclosporine (CsA) withdrawal from a sirolimus (SRL)-CsA-steroid (ST) regimen improved renal function and blood pressure. We report the protocol-mandated biopsy findings from that study. Renal transplant patients (n = 430) receiving SRL-CsA-ST were randomized at 3 months after transplantation to remain on SRL-CsA-ST, or to have CsA withdrawn (SRL-ST group). Protocol-mandated biopsies were performed at engraftment and at 12 and 36 months. Two pathologists blindly evaluated 484 biopsies to obtain the Chronic Allograft Damage Index (CADI) scores. At 36 months among patients with serial biopsies (n = 63), the mean CADI score was significantly lower with SRL-ST(4.70 vs. 3.20, p = 0.003), as was the mean tubular atrophy score (0.77 vs. 0.32, p < 0.001). All six components of the CADI score were numerically lower in SRL-ST group; moreover, inflammation and the tubular atrophy scores decreased significantly in the SRL-ST group between 12 and 36 months. The calculated glomerular filtration rate at 36 months was significantly better in the CsA-withdrawal group (54.8 vs. 68.2 mL/min, p = 0.009). In conclusion, withdrawing CsA from the SRL-CsA-ST regimen resulted in improved renal histology and function.
id RCAP_f6750fecb9ea52ab29b10938a6662075
oai_identifier_str oai:rihuc.huc.min-saude.pt:10400.4/195
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 yearsCiclosporinaImunossupressoresTransplantação de RimSirolimusGraft function and histology are predictive of renal transplant survival. The Rapamune Maintenance Regimen study demonstrated that early cyclosporine (CsA) withdrawal from a sirolimus (SRL)-CsA-steroid (ST) regimen improved renal function and blood pressure. We report the protocol-mandated biopsy findings from that study. Renal transplant patients (n = 430) receiving SRL-CsA-ST were randomized at 3 months after transplantation to remain on SRL-CsA-ST, or to have CsA withdrawn (SRL-ST group). Protocol-mandated biopsies were performed at engraftment and at 12 and 36 months. Two pathologists blindly evaluated 484 biopsies to obtain the Chronic Allograft Damage Index (CADI) scores. At 36 months among patients with serial biopsies (n = 63), the mean CADI score was significantly lower with SRL-ST(4.70 vs. 3.20, p = 0.003), as was the mean tubular atrophy score (0.77 vs. 0.32, p < 0.001). All six components of the CADI score were numerically lower in SRL-ST group; moreover, inflammation and the tubular atrophy scores decreased significantly in the SRL-ST group between 12 and 36 months. The calculated glomerular filtration rate at 36 months was significantly better in the CsA-withdrawal group (54.8 vs. 68.2 mL/min, p = 0.009). In conclusion, withdrawing CsA from the SRL-CsA-ST regimen resulted in improved renal histology and function.Blackwell ScienceRIHUCMota, AArias, MTaskinen, EIPaavonen, TBrault, YLegendre, C2008-11-27T15:00:04Z20042004-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.4/195engAm J Transplant. 2004 Jun;4(6):953-61info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-11T14:21:20Zoai:rihuc.huc.min-saude.pt:10400.4/195Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:03:02.483477Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
title Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
spellingShingle Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
Mota, A
Ciclosporina
Imunossupressores
Transplantação de Rim
Sirolimus
title_short Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
title_full Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
title_fullStr Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
title_full_unstemmed Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
title_sort Sirolimus-based therapy following early cyclosporine withdrawal provides significantly improved renal histology and function at 3 years
author Mota, A
author_facet Mota, A
Arias, M
Taskinen, EI
Paavonen, T
Brault, Y
Legendre, C
author_role author
author2 Arias, M
Taskinen, EI
Paavonen, T
Brault, Y
Legendre, C
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv RIHUC
dc.contributor.author.fl_str_mv Mota, A
Arias, M
Taskinen, EI
Paavonen, T
Brault, Y
Legendre, C
dc.subject.por.fl_str_mv Ciclosporina
Imunossupressores
Transplantação de Rim
Sirolimus
topic Ciclosporina
Imunossupressores
Transplantação de Rim
Sirolimus
description Graft function and histology are predictive of renal transplant survival. The Rapamune Maintenance Regimen study demonstrated that early cyclosporine (CsA) withdrawal from a sirolimus (SRL)-CsA-steroid (ST) regimen improved renal function and blood pressure. We report the protocol-mandated biopsy findings from that study. Renal transplant patients (n = 430) receiving SRL-CsA-ST were randomized at 3 months after transplantation to remain on SRL-CsA-ST, or to have CsA withdrawn (SRL-ST group). Protocol-mandated biopsies were performed at engraftment and at 12 and 36 months. Two pathologists blindly evaluated 484 biopsies to obtain the Chronic Allograft Damage Index (CADI) scores. At 36 months among patients with serial biopsies (n = 63), the mean CADI score was significantly lower with SRL-ST(4.70 vs. 3.20, p = 0.003), as was the mean tubular atrophy score (0.77 vs. 0.32, p < 0.001). All six components of the CADI score were numerically lower in SRL-ST group; moreover, inflammation and the tubular atrophy scores decreased significantly in the SRL-ST group between 12 and 36 months. The calculated glomerular filtration rate at 36 months was significantly better in the CsA-withdrawal group (54.8 vs. 68.2 mL/min, p = 0.009). In conclusion, withdrawing CsA from the SRL-CsA-ST regimen resulted in improved renal histology and function.
publishDate 2004
dc.date.none.fl_str_mv 2004
2004-01-01T00:00:00Z
2008-11-27T15:00:04Z
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://hdl.handle.net/10400.4/195
url http://hdl.handle.net/10400.4/195
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Am J Transplant. 2004 Jun;4(6):953-61
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Blackwell Science
publisher.none.fl_str_mv Blackwell Science
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799131695543222272