Prospective comparison of the use of sirolimus and cyclosporine in recipients of a kidney from an expanded criteria donor

被引：53

作者：

Durrbach, Antoine ^{[2
]}

Rostaing, Lionel ^{[3
]}

Tricot, Leila ^{[1
]}

Ouali, Nacera ^{[4
]}

Wolf, Philippe ^{[5
]}

Pouteil-Noble, Claire ^{[6
]}

Kessler, Michele ^{[7
]}

Viron, Beatrice ^{[8
]}

Thervet, Eric ^{[1
]}

机构：

[1] Hop Necker Enfants Malad, Serv Transplantat Renale, Dept Renal Transplantat, F-75743 Paris 15, France

[2] Hop Kremlin Bicetre, Dept Nephrol & Transplantat, Paris, France

[3] Hop Rangueil, Dept Nephrol & Multiorgan Transplantat, Toulouse, France

[4] Hop Tenon, Dept Nephrol, F-75970 Paris, France

[5] Hop Hautepierre, Dept Surg, Strasbourg, France

[6] Hop Lyon Sud, Dept Nephrol & Renal Transplantat, Pierre Benite, France

[7] Hop Brabois, Dept Nephrol, Nancy, France

[8] Hop Bichat Claude Bernard, Dept Nephrol, F-75877 Paris, France

来源：

TRANSPLANTATION | 2008年 / 85卷 / 03期

关键词：

delayed graft function; expanded criteria donor; sirolimus; renal transplantation;

D O I：

10.1097/TP.0b013e318160d3c9

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

A 6-month, open-label, multicenter prospective pilot study was conducted to evaluate the effects of sirolimus (SRL) versus cyclosporine (CsA) in recipients of kidneys from expanded criteria donors. All patients also received antithymocyte globulins induction, mycophenolate mofetil, and steroids. Sixty-nine patients (33 SRL, 36 CsA) were randomized. More patient were withdrawn in the SRL group (16 vs. 6, P<0.01), because of delayed graft function and surgical complications. Delayed graft function tended to be more frequent with SRL than with CsA (45.4% vs. 30.6%, P=0.22). Graft survival was numerically lower in the SRL group (87.5% vs. 97%, P=0.19). At 6 months, there were no significant differences in biopsy-proven acute rejection or calculated creatinine clearance (SRL 12.1% vs. CsA 8.3%; P=0.7 and 44.7 16.6 vs. 41.9 15.2 mL/min; P=0.54 respectively). These results do not support the use of SRL immediately after transplantation in expanded criteria donor recipients.

引用

页码：486 / 490

页数：5

共 21 条

[1] Comparison of acute rapamycin nephrotoxicity with cyclosporine and FK506 [J].

Andoh, TF ;

Burdmann, EA ;

Fransechini, N ;

Houghton, DC ;

Bennett, WM .

KIDNEY INTERNATIONAL, 1996, 50 (04) :1110-1117

[2] THE EFFECT OF RAPAMYCIN ON KIDNEY-FUNCTION IN THE SPRAGUE-DAWLEY RAT [J].

DIJOSEPH, JF ;

SHARMA, RN ;

CHANG, JY .

TRANSPLANTATION, 1992, 53 (03) :507-513

[3] De novo kidney transplantation without use of calcineurin inhibitors preserves renal structure and function at two years [J].

Flechner, SM ;

Kurian, SM ;

Solez, K ;

Cook, DJ ;

Burke, JT ;

Rollin, H ;

Hammond, JA ;

Whisenant, T ;

Lanigan, CM ;

Head, SR ;

Salomon, DR .

AMERICAN JOURNAL OF TRANSPLANTATION, 2004, 4 (11) :1776-1785

[4] Sirolimus delays recovery of rat kidney transplants after ischemia-reperfusion injury [J].

Fuller, TF ;

Freise, CE ;

Serkova, N ;

Niemann, CU ;

Olson, JL ;

Feng, S .

TRANSPLANTATION, 2003, 76 (11) :1594-1599

[5] Sirolimus and lymphocele formation after kidney transplantation: an immunosuppressive medication as co-factor for a surgical problem? [J].

Giessing, M ;

Budde, K .

NEPHROLOGY DIALYSIS TRANSPLANTATION, 2003, 18 (02) :448-449

[6] Improved renal function in sirolimus-treated renal transplant patients after early cyclosporine elimination [J].

Gonwa, TA ;

Hricik, DE ;

Brinker, K ;

Grinyo, JM ;

Schena, FP .

TRANSPLANTATION, 2002, 74 (11) :1560-1567

[7] Incidence, therapy, and consequences of lymphocele after sirolimus-cyclosporine-prednisone immunosuppression in renal transplant recipients [J].

Langer, RM ;

Kahan, BD .

TRANSPLANTATION, 2002, 74 (06) :804-808

[8] Ischemia-reperfusion induces glomerular and tubular and activation of proinflammatory and antiapoptotic pathways: Differential modulation by rapamycin [J].

Loverre, A ;

Ditonno, P ;

Crovace, A ;

Gesualdo, L ;

Ranieri, E ;

Pontrelli, P ;

Stallone, G ;

Infante, B ;

Schena, A ;

Di Paolo, S ;

Capobianco, C ;

Ursi, M ;

Palazzo, S ;

Battaglia, M ;

Selvaggi, FP ;

Schena, FP ;

Grandaliano, G .

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2004, 15 (10) :2675-+

[9] Comparison of outcomes after delayed graft function: Sirolimus-based versus other calcineurin-inhibitor sparing induction immunosuppression regimens [J].

McTaggart, RA ;

Tomlanovich, S ;

Bostrom, A ;

Roberts, JP ;

Feng, S .

TRANSPLANTATION, 2004, 78 (03) :475-480

[10] Sirolimus prolongs recovery from delayed graft function after cadaveric renal transplantation [J].

McTaggart, RA ;

Gottlieb, D ;

Brooks, J ;

Bacchetti, P ;

Roberts, JP ;

Tomlanovich, S ;

Feng, S .

AMERICAN JOURNAL OF TRANSPLANTATION, 2003, 3 (04) :416-423

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