Conversion From Azathioprine to Mycophenolate Mofetil Followed by Calcineurin Inhibitor Minimization or Elimination in Patients With Chronic Allograft Dysfunction

Garcia, Ricardo M; Pinheiro-Machado, Paula G.; Felipe, Cláudia Rosso; Park, S.I.; Silva, L.A.; Franco, Marcello; Tedesco‐Silva, Hélio; Medina-Pestana, J.O.

doi:10.1016/j.transproceed.2006.10.001

Cited by 10 publications

(3 citation statements)

References 20 publications

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“…Steroid withdrawal has been attempted in various protocols over the last decade, and though successful in selected patients (5), can result in unacceptably high rates of acute rejection and even graft loss (6)(7)(8)(9)(10). Steroid minimization does not always eliminate all steroid-related side effects (11)(12)(13), which has led to an interest in developing protocols to avoid maintenance steroids in renal transplantation, under the umbrella of more powerful immunosuppressive agents for induction and maintenance therapy (14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Steroid-Free Immunosuppression Since 1999: 129 Pediatric Renal Transplants with Sustained Graft and Patient Benefits

Li¹,

Chang²,

Naesens³

et al. 2009

American Journal of Transplantation

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Despite early promising patient and graft outcomes with steroid-free (SF) immunosuppression in pediatric kidney transplant recipients, data on long-term safety and efficacy results are lacking. We present our singlecenter experience with 129 consecutive pediatric kidney transplant recipients on SF immunosuppression, with a mean follow-up of 5 years. Outcomes are compared against a matched cohort of 57 concurrent recipients treated with steroid-based (SB) immunosuppression. In the SF group, 87% of kidney recipients with functioning grafts remain corticosteroid-free. Actual intent-to-treat SF (ITT-SF) and still-on-protocol SF patient survivals are 96% and 96%, respectively, actual graft survivals for both groups are 93% and 96%, respectively and actual death-censored graft survivals for both groups are 97% and 99%, respectively. Unprecedented catch-up growth is observed in SF recipients below 12 years of age. Continued low rates of acute rejection, posttransplant diabetes mellitus (PTDM), hypertension and hyperlipidemia are seen in SF patients, with sustained benefits for graft function. In conclusion, extended enrollment and longer experience with SF immunosuppression for renal transplantation in low-risk children confirms protocol safety, continued benefits for growth and graft function, low acute rejection rates and reduced cardiovascular morbidity.

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Section: Introductionmentioning

confidence: 99%

Steroid-Free Immunosuppression Since 1999: 129 Pediatric Renal Transplants with Sustained Graft and Patient Benefits

Li¹,

Chang²,

Naesens³

et al. 2009

American Journal of Transplantation

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“…28 Three years after conversion to MMF in patients with progressive CAN, patient and graft survival were reported to be 95% and 79%, respectively. 29 In a large cohort, MMF reduced the relative risk for CAN development by 27%. 30 In a study evaluating the effect of immunosuppression conversion on CAN progression, MMF or low dose CsA was superior to TAC-for-CsA and standard dose CsA in patients with CAN, at least in the short term.…”

Section: Discussionmentioning

confidence: 98%

Effect of conversion from azathioprine to mycophenolate mofetil on renal function in stable kidney transplant recipients

Usta

Ayar

2019

Turkish Journal of Internal Medicine

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Introduction. This study investigated the effect of mycophenolate mofetil (MPA) treatment instead of azathioprine (AZA) on renal function after kidney transplantation. Methods. Thirteen of all recipients were taking a cyclosporine-based regimen and serum creatinine levels were above 1.5 mg/dL. In 13 patients, MPA treatment was started instead of AZA. Renal functions were evaluated for 12 months after MPA treatment. Results. Serum creatinine levels increased from 2.11±0.48 mg/dL to 2.16±0.72 mg/dL at 12th months. This increase was not statistically significant. Serum creatinine levels decreased in 5 of 13 patients. Conclusions. In selected patients, conversion from AZA to MPA may slow down the rate of deterioration in graft functions.

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“…Outros autores também confirmaram o efeito benéfico da conversão para MMF com redução ou suspensão de inibidores de calcineurina em adultos (44)(45)(46) e crianças (47,48) . (50) .…”

Section: Esquemas De Minimização De Inibidores Da Calcineurinaunclassified

Efeito da conversão para sirolimo comparada à manutenção de baixos níveis de inibidores de calcineurina na progressão da nefropatia crônica do enxerto em transplantados renais

Prado¹

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Conversion From Azathioprine to Mycophenolate Mofetil Followed by Calcineurin Inhibitor Minimization or Elimination in Patients With Chronic Allograft Dysfunction

Cited by 10 publications

References 20 publications

Steroid-Free Immunosuppression Since 1999: 129 Pediatric Renal Transplants with Sustained Graft and Patient Benefits

Steroid-Free Immunosuppression Since 1999: 129 Pediatric Renal Transplants with Sustained Graft and Patient Benefits

Effect of conversion from azathioprine to mycophenolate mofetil on renal function in stable kidney transplant recipients

Efeito da conversão para sirolimo comparada à manutenção de baixos níveis de inibidores de calcineurina na progressão da nefropatia crônica do enxerto em transplantados renais

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