Renal Transplant Function After Ten Years of Cyclosporine

Almond, P. S.; Gillingham, Kristen J.; Sibley, Richard K.; Moss, Adyr; Melin, M. Mark; Leventhal, Joseph R.; Manivel, Carlos; Kyriakides, Polina N.; Payne, William D.; Dünn, David L.; Sutherl, David E. R.; Gores, P. F.; Najarían, John S.; Matas, Arthur J.

doi:10.1097/00007890-199202010-00012

Cited by 73 publications

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“…Despite the use of cyclosporin A (CyA)-based immunosuppression protocols, the graft rejection rate after kidney transplantation is around 50 YO [1], FK506 is a macrolide lactone produced by the fungus Streptomyces tsukubaensis with immunosuppressive activity. FK 506 has a completely different molec-50 Yo in patients converted because of chronic rejection, and 83 % in patients converted because of CyA toxicity.…”

Section: Introductionmentioning

confidence: 99%

Rescue therapy with tacrolimus (FK 506) in renal transplant recipients -a Scandinavian multicenter analysis

et al. 1997

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All renal allograft recipients (n = 32) in Sweden and Norway who were converted from cyclosporin( CyA)-based immunosuppression to FK 506 (tacrolimus) between October 1992 and June 1995 were analyzed retrospectively. The reasons for conversion were acute refractory rejection (n = 21), chronic rejection (n = 4), and suspected CyA toxicity (n = 6); one patient was converted for psychological reasons. The mean time from transplantation to conversion was 29 (range 1-243) weeks and there was a mean follow-up of 46 (2-143) weeks.Overall graft survival was 59 YO, with graft survival 52 % in patients converted because of acute rejection,

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Section: Introductionmentioning

confidence: 99%

Rescue therapy with tacrolimus (FK 506) in renal transplant recipients -a Scandinavian multicenter analysis

et al. 1997

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“…The nephrotoxic properties of CsA are well known and long-term use of this drug has been associ ated with irreversible loss of graft function due to vascular obliteration and interstitial fibrosis (3), although recent data on this issue are less worrisome (4,5). In addition, CsA importantly contributes to posttransplant hypertension (6) and has also been implicated in the pathogenesis of hyper cholesterolemia in these patients (2).…”

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confidence: 99%

Randomized, Prospective Trial of Cyclosporine Monotherapy Versus Azathioprine-Prednisone From Three Months After Renal Transplantation1

Hilbrands¹,

Hoitsma²,

Koene³

1996

Transplantation

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“…Amend et al [2] and Klare et al [10] have reported that renal function in CyA-treated renal transplants is stable for over 5 years after kidney transplantation. Land et al [11] have demonstrated stable renal function for 8 years in CyA-treated renal transplant recipients, and Almond et al [1] have also reported that indefinite CyA administration does not cause progressive deterioration of transplant renal function. Recently, BenMaimon et al [3] have reported that renal allograft recipients who do not experience acute rejection can be maintained on CyA for as long as 5 years without showing any deterioration of renal function as measured by serum levels of creatinine, contrasting with the definite long-term deterioration of function seen in those patients experiencing acute rejection.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, some reports suggest that apart from CyA nephrotoxicity, other factors such as HLA typing, acute rejection episodes, and donor age, among others, might affect long-term renal transplant survival [1,12]. For example, there is controversy about the impact of HLA-AB and -DR donor-recipient matching on cadaveric donor renal allograft survival.…”

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confidence: 99%

“…Some data from large registries indicate a significant benefit in graft survival for recipients of well-matched grafts [18,19]. Contrary to these reports, the beneficial effect of HLA matching on the long-term result of renal transplantation has not been confirmed by other studies [1,8]. Also, some authors have suggested that rejection episodes might have a negative impact on long-term renal transplant survival [1,11,12].…”

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Causes of long-term graft failure in renal transplantation

Tanabe¹,

Takahashi²,

Toma³

1996

World J Urol

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A single-center experience of 980 consecutive renal transplant recipients treated with cyclosporine (CyA) was reviewed to analyze the causes of renal allograft loss and the factors affecting long-term renal survival in CyA-treated kidney transplants. In all, 217 grafts were lost during the observation period, with the most common causes of graft loss being chronic rejection (96 cases, 44%), death with a functioning graft (52 cases, 24%), glomerulonephritis (28 cases, 13%), and acute rejection (20 cases, 8%). The actuarial 10-year survival of patients with living and cadaveric grafts was 93% and 91%, respectively. The actuarial 10-year survival of living and cadaveric grafts was 70% and 63%, respectively. Patients were divided into two groups, namely a graft-survival group (n = 763) and a graft-loss group (n = 217). There was no significant difference between the two groups in terms of sex, donor source, donor age, recipient age, duration of hemodialysis, retransplants, transfusions, presensitization, of HLA match. There was no difference between the graft-survival group and the graft-loss group in the mean CyA dose given or the mean CyA trough level measured at any time following transplantation. Acute rejection episodes occurred in patients from the graft-survival group (55%) as compared with those from the graft-loss group (83%; P < 0.00001). These data suggest that long-term graft survival in CyA-treated kidney transplant patients is primarily influenced by the occurrence of rejection episodes rather than by the drug dose or the duration of CyA administration. CyA nephrotoxicity was not the major risk factor for long-term graft survival in CyA-treated renal transplants.

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Renal Transplant Function After Ten Years of Cyclosporine

Cited by 73 publications

References 0 publications

Rescue therapy with tacrolimus (FK 506) in renal transplant recipients -a Scandinavian multicenter analysis

Rescue therapy with tacrolimus (FK 506) in renal transplant recipients -a Scandinavian multicenter analysis

Randomized, Prospective Trial of Cyclosporine Monotherapy Versus Azathioprine-Prednisone From Three Months After Renal Transplantation1

Causes of long-term graft failure in renal transplantation

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