2014
DOI: 10.5500/wjt.v4.i2.57
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Calcineurin inhibitor sparing strategies in renal transplantation, part one: Late sparing strategies

Abstract: Kidney transplantation improves quality of life and reduces the risk of mortality. A majority of the success of kidney transplantation is attributable to the calcineurin inhibitors (CNIs), cyclosporine and tacrolimus, and their ability to reduce acute rejection rates. However, long-term graft survival rates have not improved over time, and although controversial, evidence does suggest a role of chronic CNI toxicity in this failure to improve outcomes. Consequently, there is interest in reducing or removing CNI… Show more

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Cited by 18 publications
(14 citation statements)
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“…As pointed out by Kamar et al . in this issue, MPA‐based minimization leads to better renal function . Although there have been several studies of the potential for CNI‐free protocols with MPA and steroids, complete CNI avoidance or withdrawal over the first 3 years has been associated with an increased rejection risk and worse outcomes in prospective randomized studies .…”
Section: Current Strategies Of Immunosuppression Minimizationmentioning
confidence: 99%
See 1 more Smart Citation
“…As pointed out by Kamar et al . in this issue, MPA‐based minimization leads to better renal function . Although there have been several studies of the potential for CNI‐free protocols with MPA and steroids, complete CNI avoidance or withdrawal over the first 3 years has been associated with an increased rejection risk and worse outcomes in prospective randomized studies .…”
Section: Current Strategies Of Immunosuppression Minimizationmentioning
confidence: 99%
“…For severe CNI‐related side effects, such as nephrotoxicity, CNI withdrawal, replacement, or profound, reduction is needed. Special attention should be paid to maintenance patients, which need less CNIs than previously thought . It is important to note that CNIs maintenance does not influence other important factors such as adherence, recurrent disease, and chronic antibody‐mediated rejection.…”
Section: Current Strategies Of Immunosuppression Minimizationmentioning
confidence: 99%
“…Cyclosporine A (CSA) is a widely used immunosuppressant in organ transplantation (61)(62)(63), or in treatment of children with aplastic anemia (64,65) and other autoimmune diseases (66)(67)(68). CSA binds to the cytosolic protein cyclophilin and inhibits calcineurin of T cells, consequently suppressing transcription of IL-2 (69)(70)(71)(72)(73).…”
mentioning
confidence: 99%
“…13,14 Cyclosporine A (CsA) is a widely used immunosuppressant in organ transplantation and treatment of autoimmune diseases. 15,16 Moreover, the concept of immunizing with antigen together with an immunosuppressant to induce Treg cells (iTreg) and effectively treat autoimmune diseases has previously been proven in animal models in our lab. 17,18 The RSV G protein functions as an attachment protein during RSV infection and has been selected as a vaccine antigen candidate in many approaches.…”
Section: Introductionmentioning
confidence: 99%