Late renal allograft loss: noncompliance masquerading as chronic rejection

Gaston, Robert S.; Hudson, Sharon L.; Ward, Mary Traver; Jones, Patricia A.; Macon, R.

doi:10.1016/s0041-1345(99)00118-9

Cited by 105 publications

(75 citation statements)

References 5 publications

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“…In this regard, in the present report, there is no difference in patient and graft survival among racial groups during the first year post transplantation (100% follow-up), perhaps because equal access was provided to any patient without considering the type of health insurance coverage. As an additional support of this, chronic rejection, the commonest cause of late allograft loss, has been predominantly attributed to noncompliance (18).…”

Section: Discussionmentioning

confidence: 99%

The Use of Daclizumab, Tacrolimus and Mycophenolate Mofetil in African‐American and Hispanic First Renal Transplant Recipients

Ciancio¹,

Burke²,

Suzart³

et al. 2003

American Journal of Transplantation

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Limited data are available on the use of tacrolimus and mycophenolate mofetil in conjunction with anti-IL-2 receptor antibody, in groups of kidney transplant recipients considered to be at higher risk. This study compared the incidence of acute rejection between African-American (AA), Hispanic (H), and non-AfricanAmerican, non-Hispanics (non-AA, non-H) first renal transplant recipients. We studied 233 sequential first renal transplants. Of the 233, 37 recipients (16%) were AA, 85 (36.5%) were H and 111 (47.5%) were non-AA, non-H. All received daclizumab induction therapy (1 mg/kg) on the day of surgery, and every other week for a total of 5 doses, as well as mycophenolate mofetil, tacrolimus, and steroids. At 1 year, patient and graft survival were 97% and 95% in AA, 98% and 98% in H, and 96% and 95% in non-AA, non-H, respectively (not statistically different). Biopsy-proven acute rejection episodes were 8.1% in AA, 4.7% in H, and 4.5% in non-AA, non-H (also not statistically different). This immunosuppressive protocol appears to be safe and effective in helping to minimize biopsy-proven acute rejection and optimize renal allograft survival in African-American and Hispanic renal transplant recipients in the first year post transplantation.

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Section: Discussionmentioning

confidence: 99%

The Use of Daclizumab, Tacrolimus and Mycophenolate Mofetil in African‐American and Hispanic First Renal Transplant Recipients

Ciancio¹,

Burke²,

Suzart³

et al. 2003

American Journal of Transplantation

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“…First, we measured adherence prospectively using microelectronic monitors rather than traditional and limited methods, such as drug levels (2), patient self-reports (4,5,38,39), pill counts (40), prescription refill records (3,41), clinic attendance, or combinations of these measures (2,7,16,18). Microelectronic monitors provide higher quality adherence data than these traditional methods (19 -22).…”

Section: Discussionmentioning

confidence: 99%

“…Decreased adherence to immunosuppressive medications is associated with acute rejection (5,6) and seven-fold higher odds of allograft failure (1). Decreased adherence commonly causes late allograft loss (7) and precedes more than one third of allograft failures (1).…”

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confidence: 99%

Race and Electronically Measured Adherence to Immunosuppressive Medications after Deceased Donor Renal Transplantation

Weng¹,

Israni²,

Joffe³

et al. 2005

Journal of the American Society of Nephrology

172

148

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Nonadherence to immunosuppressive medications may partly explain the worse allograft outcomes among black recipients of renal transplants. In a prospective cohort study of recipients of deceased donor renal transplants, microelectronic cap monitors were placed on bottles of one immunosuppressive medication to (1) measure average daily percentage adherence during the first posttransplantation year and (2) determine the factors associated with adherence. A total of 278 transplant recipients who provided sufficient microelectronic adherence data were grouped into four categories of average daily percentage adherence: 95 to 100% adherence (41.0% of patients), 80 to 95% adherence (32.4%), 50 to 80% adherence (12.9%), and 0 to 50% adherence (13.7%). In the unadjusted ordinal logistic regression model, black race was associated with decreased adherence (odds ratio [

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“…A prolongedrelease tacrolimus formulation (Advagraf, Astellas Pharma Europe Ltd, Staines, UK; referred to as Tacrolimus QD) allows once-daily dosing, with the potential for improving treatment adherence. Nonadherence is a major cause of preventable graft loss (1)(2)(3). Interventions that improve treatment adherence, such as morning dosing and reducing administration frequency (4,5), may also improve longterm outcomes (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Tacrolimus Once Daily (ADVAGRAF) Versus Twice Daily (PROGRAF) in De Novo Renal Transplantation: A Randomized Phase III Study

Krämer

Charpentier

Bäckman

et al. 2010

American Journal of Transplantation

162

135

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This multicenter, 1:1-randomized, parallel-group, noninferiority study compared the efficacy and safety of twice-daily tacrolimus (Tacrolimus BID; Prograf) and once-daily tacrolimus prolonged release (Tacrolimus QD; Advagraf), combined with steroids and low-dose mycophenolate mofetil without antibody induction, in 667 de novo kidney transplant recipients. A doubleblind, double-dummy 24-week period was followed by an open extension of up to 12 months posttransplant. Biopsy-proven acute rejection rate at 24 weeks (primary endpoint, per-protocol analysis) was 15.8% for Tacrolimus BID versus 20.4% for Tacrolimus QD (p = 0.182; treatment difference 4.5%, 95% confidence interval--1.8%, 10.9%, just outside the prespecified 10% noninferiority margin). Kaplan-Meier 12-month patient and graft survival rates were 97.5% and 92.8% for Tacrolimus BID and 96.9% and 91.5% for QD. Both treatment groups showed equally wellmaintained renal function at 12 months (mean creatinine clearance approximately 67 mL/min) and similar adverse event profiles. Overall results obtained with either Tacrolimus QD or BID, without antibody induction, were good, supporting use of the once-daily formulation as an effective alternative to the established twice-daily formulation.

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Late renal allograft loss: noncompliance masquerading as chronic rejection

Cited by 105 publications

References 5 publications

The Use of Daclizumab, Tacrolimus and Mycophenolate Mofetil in African‐American and Hispanic First Renal Transplant Recipients

The Use of Daclizumab, Tacrolimus and Mycophenolate Mofetil in African‐American and Hispanic First Renal Transplant Recipients

Race and Electronically Measured Adherence to Immunosuppressive Medications after Deceased Donor Renal Transplantation

Tacrolimus Once Daily (ADVAGRAF) Versus Twice Daily (PROGRAF) in De Novo Renal Transplantation: A Randomized Phase III Study

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