2019
DOI: 10.1001/jamanetworkopen.2019.10297
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Survival Associated With Sirolimus Plus Tacrolimus Maintenance Without Induction Therapy Compared With Standard Immunosuppression After Lung Transplant

Abstract: Key Points Question Which immunosuppressive strategy is associated with the highest survival in lung transplantation? Findings In this cohort study of US recipients of lung transplants, sirolimus plus tacrolimus was associated with significantly better conditional survival from 1 year after transplant compared with mycophenolate mofetil plus tacrolimus (median survival, 8.9 vs 7.1 years after transplant). The highest conditional survival was observed in pat… Show more

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Cited by 12 publications
(4 citation statements)
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“…The patient’s survival to 12 years after transplant and 13 years after the initial diagnosis, despite his multiple sequential recurrences, is in stark contrast to the lethal natural history of the lung-limited, lepidic-predominant adenocarcinoma, 1 far exceeding the typical long-term survival in patients who received lung transplantation for this type of cancer 4 , 10 or for any indication. 11 This case supports the notion that concern for a high rate of recurrence after lung transplantation should be weighed against the ability to sequentially salvage recurrences with close radiographic surveillance.…”
Section: Discussionsupporting
confidence: 71%
“…The patient’s survival to 12 years after transplant and 13 years after the initial diagnosis, despite his multiple sequential recurrences, is in stark contrast to the lethal natural history of the lung-limited, lepidic-predominant adenocarcinoma, 1 far exceeding the typical long-term survival in patients who received lung transplantation for this type of cancer 4 , 10 or for any indication. 11 This case supports the notion that concern for a high rate of recurrence after lung transplantation should be weighed against the ability to sequentially salvage recurrences with close radiographic surveillance.…”
Section: Discussionsupporting
confidence: 71%
“…De fato, a terapia de indução, tacrolimus em vez de ciclosporina e transplante bilateral estão em consonância com a atividade clínica mais recente do centro, em paralelo com a literatura e com a experiência adquirida pela equipe do centro. (28,29) Na coorte FP, o uso de basiliximabe mostrou-se associado a melhor resultado em termos de sobrevida global e sobrevida livre de CLAD (p = 0,05, HR = 0,503 [0,247-1,027] e p = 0,003, HR = 0,165 [0,050-0,543], respectivamente). A maioria dos pacientes com FPF foi transplantada desde 2009, quando o protocolo já havia sofrido alterações substanciais (apenas um paciente foi transplantado anteriormente, em 2006).…”
Section: /9unclassified
“…Of note, in one retrospective review utilizing data from the UNOS registry, 219 patients receiving sirolimus were compared with 5,782 patients receiving MMF. 265 Conditioned on 1-year survival and excluding patients with malignancy or chronic rejection in the first year, sirolimus treatment was associated with significantly better survival.…”
Section: Maintenance Immune Suppressionmentioning
confidence: 98%