Early cyclosporine a withdrawal in kidney transplant recipients under a sirolimus-based immunosuppressive regimen: pathological study of graft biopsies at 1-year posttransplant

Ruiz, J.C.; Campistol, Josep M.; Mota, A.; Prats, D; Gutiérrez, A. Domínguez; Castro, Ana; Pinto, J.R.; García, Javier Moreno; Morales, José; Grinyó, J.; Arias, Manuel

doi:10.1016/s0041-1345(01)02827-5

Cited by 5 publications

(7 citation statements)

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“…Nevertheless, an improvement in long-term graft outcome should be associated with a reduction in graft pathologic lesions and a subsequent decrease in the incidence and severity of CAN. Our previous report suggested this hypothesis but the results were inconclusive because of limitations in the study design (11).…”

Section: Discussionmentioning

confidence: 94%

“…We evaluated 140 renal biopsies in patients with a functioning allograft at 1 year, corresponding with the baseline (pretransplant) and 1-year biopsies of the 70 patients recruited in the 10 centers participating in Spain and Portugal (11). In that substudy, we performed a retrospective analysis of the information supplied by the 10 local pathologists (according to the Banff '95 classification) and observed a lower rate of progression of chronic allograft pathologic lesions when CsA was eliminated.…”

mentioning

confidence: 99%

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Early Cyclosporine A Withdrawal in Kidney-Transplant Recipients Receiving Sirolimus Prevents Progression of Chronic Pathologic Allograft Lesions

et al. 2004

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Section: Discussionmentioning

confidence: 94%

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confidence: 99%

Early Cyclosporine A Withdrawal in Kidney-Transplant Recipients Receiving Sirolimus Prevents Progression of Chronic Pathologic Allograft Lesions

et al. 2004

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“…One hundred fourteen graft biopsies corresponding to 57 of the subgroup of 70 patients (81%) reported in our previous article 6 were reevaluated by a central pathologist (J.M.G.) in a blinded manner.…”

Section: Methodsmentioning

confidence: 99%

“…Differences in renal function at 1 year were reported in a previous study. 6 We considered the presence of progression when any given Banff or CADI code was higher in the 1-year biopsy than in the transplant (basal) biopsy; when it was equal or lower it was considered nonprogression. Chronicity scores were analyzed in the same way.…”

Section: Methodsmentioning

confidence: 99%

“…5 Using a substudy of this trial, including 70 patients in the ten centers participating in Spain and Portugal, we hypothesized a lower rate of progression of chronic allograft pathologic lesions when CyA was eliminate based upon a retrospective analysis of the information supplied by ten local pathologists. 6 Herein we present the results of a prospective reanalysis of the renal biopsies of this subgroup of patients by a central, blinded pathologist.…”

Section: Hronic Allograft Nephropathy (Can)mentioning

confidence: 99%

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Early elimination of cyclosporine in kidney transplant recipients receiving sirolimus prevents progression of chronic pathologic allograft lesions

Ruiz

Campistol

Mota

et al. 2003

Transplantation Proceedings

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Cyclosporine elimination in a regimen including sirolimus has been shown to be a safe and effective approach to improve graft function. Nevertheless, it is still unknown whether the functional benefit of CyA withdrawal coincides with a subsequent reduction in histologic lesions of chronic damage or development of chronic allograft nephropathy. This consideration would forcast a reduction in the rate of long-term graft loss. We analyzed 114 graft biopsies from a subgroup of 57 patients that had been included in a randomized study to eliminate CyA at 3 months posttransplant from a regimen including sirolimus either in group A CyA ϩ SRL vs group B of SRL with CyA elimination at 3 months. Every patient had two biopsies, one at transplantation and another at 1 year. The biopsy reading was performed in a blinded manner by a central pathologist using the Banff 1997 and the CADI classifications. A significantly lower rate of progression of tubular and interstitial chronic lesions between basal and 1-year biopsies was observed for group B patients. In addition, the incidence of new cases of chronic allograft nephropathy during the first year was significantly lower in the group in which CyA had been eliminated at 3 months posttransplant. We conclude that early elimination of CyA in the first months posttransplant, when SRL is used as the main immunosuppressant, reduces the appearance or worsening of chronic histologic lesions, probably as a consequence of long-term CyA toxicity prevention.

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Forty Years of Publication of Transplantation Proceedings—The Fourth Decade: Globalization of the Enterprise

Kahan

2011

Transplantation Proceedings

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Early cyclosporine a withdrawal in kidney transplant recipients under a sirolimus-based immunosuppressive regimen: pathological study of graft biopsies at 1-year posttransplant

Cited by 5 publications

References 4 publications

Early Cyclosporine A Withdrawal in Kidney-Transplant Recipients Receiving Sirolimus Prevents Progression of Chronic Pathologic Allograft Lesions

Early Cyclosporine A Withdrawal in Kidney-Transplant Recipients Receiving Sirolimus Prevents Progression of Chronic Pathologic Allograft Lesions

Early elimination of cyclosporine in kidney transplant recipients receiving sirolimus prevents progression of chronic pathologic allograft lesions

Forty Years of Publication of Transplantation Proceedings—The Fourth Decade: Globalization of the Enterprise

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