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Conversion of stable ABO-incompatible kidney transplant recipients from mycophenolate mofetil with standard exposure calcineurin inhibitors (CNIs) to everolimus with very low exposure CNIs-a short-term pilot study.

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  • معلومة اضافية
    • المصدر:
      Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Copenhagen : Munksgaard,
    • الموضوع:
      Blood Group Incompatibility* ; Calcineurin Inhibitors* ; Kidney Transplantation*; Graft Rejection/*drug therapy ; Immunosuppressive Agents/*therapeutic use ; Mycophenolic Acid/*analogs & derivatives ; Sirolimus/*analogs & derivatives; ABO Blood-Group System ; Dose-Response Relationship, Drug ; Everolimus ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Graft Survival/drug effects ; Humans ; Kidney Failure, Chronic/surgery ; Kidney Function Tests ; Male ; Middle Aged ; Mycophenolic Acid/therapeutic use ; Pilot Projects ; Prognosis ; Sirolimus/therapeutic use ; Time Factors
    • نبذة مختصرة :
      Background: A recent report has demonstrated that as with mycophenolate mofetil (MMF), everolimus is capable of inhibiting human B-lymphocyte function and activation including B-lymphocyte proliferation, apoptosis, and immunoglobulin production in vitro. Everolimus may therefore be used as an immunosuppressant in ABO-incompatible kidney transplantation.
      Methods: A three-month pilot study was performed to examine the efficacy and safety of conversion of stable ABO-incompatible kidney transplant recipients from MMF with standard exposure calcineurin inhibitors (CNIs) to everolimus with very low exposure CNIs. Sixteen recipients were enrolled in the study. The patients without acute rejection by graft biopsy were switched from MMF to everolimus with CNI minimization. At three months after conversion, graft biopsies were performed to check for acute rejection and C4d deposition.
      Results: Conversion to everolimus with CNI minimization for three months did not induce acute rejection and C4d deposition in all of the ABO-incompatible kidney transplant recipients. A slight elevation of anti-A/B antibody titer occurred in our present study. Everolimus was associated with hyperlipidemia and edema.
      Conclusions: These results demonstrated that short-term conversion from MMF to everolimus after one yr post-transplant may be a safe and effective alternate for ABO-incompatible kidney transplant recipients requiring temporary discontinuation of MMF.
      (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
    • Contributed Indexing:
      Keywords: ABO-incompatible; calcineurin inhibitor minimization; everolimus; kidney transplantation; mycophenolate mofetil
    • الرقم المعرف:
      0 (ABO Blood-Group System)
      0 (Calcineurin Inhibitors)
      0 (Immunosuppressive Agents)
      9HW64Q8G6G (Everolimus)
      HU9DX48N0T (Mycophenolic Acid)
      W36ZG6FT64 (Sirolimus)
    • الموضوع:
      Date Created: 20131217 Date Completed: 20140911 Latest Revision: 20161125
    • الموضوع:
      20250114
    • الرقم المعرف:
      10.1111/ctr.12281
    • الرقم المعرف:
      24329776