Long-term Outcome of Azathioprine Versus Mycophenolate Mofetil in Cyclosporine-Based Immunosuppression in Kidney Transplantation: 10 Years of Experience at a Single Center

Kwon, Owen; Cho, J.-H.; Choi, Ji Young; Park, S.-H.; Kim, Y.-L.; Kim, H.-K.; Huh, Seung; Kim, C.-D.

doi:10.1016/j.transproceed.2013.02.046

Cited by 7 publications

(7 citation statements)

References 18 publications

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“…When combined with cyclosporine and steroids, it has also been proven to reduce the occurrence of acute rejection during transplants, increasingly substituting for azathioprine in surgical procedures. Nonetheless, it is not without drawbacks, being linked with complications such as gastrointestinal problems, leucopenia and opportunistic infections [ 122 , 123 ].…”

Section: Immunosuppression and Patient Carementioning

confidence: 99%

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Nowacki¹,

Nazarewski²,

Kloskowski³

et al. 2016

aoms

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On the 60th anniversary of the first successfully performed renal transplantation, we summarize the historical, current and potential future status of kidney transplantation. We discuss three different aspects with a potential significant influence on kidney transplantation progress: the development of surgical techniques, the influence of regenerative medicine and tissue engineering, and changes in immunosuppression. We evaluate the standard open surgical procedures with modern techniques and compare them to less invasive videoscopic as well as robotic techniques. The role of tissue engineering and regenerative medicine as a potential method for future kidney regeneration or replacement and the interesting search for novel solutions in the field of immunosuppression will be discussed. After 60 years since the first successfully performed kidney transplantation, we can conclude that the greatest achievements are associated with the development of surgical techniques and with planned systemic immunosuppression.

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Section: Immunosuppression and Patient Carementioning

confidence: 99%

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Nowacki¹,

Nazarewski²,

Kloskowski³

et al. 2016

aoms

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“…Findings of this study are consistent with previous studies that have shown that treatment benefits and risks are similar in patients treated with AZA and MMF and that MMF therapy is not superior in preventing long-term graft loss when compared to AZA. (17,18) The effectiveness of both drugs was demonstrated in this study. Patient survival on the other hand was superior in the MMF group.…”

Section: Discussionmentioning

confidence: 56%

Outcomes of Cadaveric Renal Transplantation Using Mycophenolate Mofetil or Azathioprine in South Africa

Gathara¹,

Naicker²

2019

Wits Journal of Clinical Medicine

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Introduction: Mycophenolate mofetil (MMF) has, to a great extent, replaced azathioprine (AZA) in immunosuppressive regimens worldwide in the prevention of acute allograft rejection. However, there are no studies in South Africa to show that MMF is superior to AZA. Objectives: To describe the outcomes of cadaveric renal transplantation in patients treated with either MMF or AZA and followed up over a 5-year period. Design: This was a retrospective comparative study. Methods: A convenience sample of all eligible patients, 208 in total, was recruited from the Renal Transplant Unit at the Charlotte Maxeke Johannesburg Academic Hospital from 1985 to 2013, who were treated with either MMF or AZA. Results: Of the 208 patients, 101 patients were treated with AZA and 107 patients treated with MMF, in addition to corticosteroids and cyclosporine. A total of 16 patients developed acute allograft rejection 12-52 weeks after cadaveric transplantation. Of these, 6% were in the AZA group and 10% in the MMF group. There was a 1% mortality in the MMF group and 16.8% in the AZA group (p < 0.001). The serum creatinine at a 3-month follow-up was found to be a strong predictor of allograft function in patients on MMF (p < 0.001). Conclusion: Patient survival was superior in the long term in cadaveric renal transplant patients receiving MMF therapy.

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“…Previous studies have consistently found AR to occur much less frequently in transplant recipients on tacrolimus therapy . Compared with azathioprine, MMF reduced the incidence of AR in recent study . Thus, AR may be affected by different immunosuppressive regimens.…”

Section: Discussionmentioning

confidence: 85%

Association studies of cytochrome P450, family 2, subfamily E, polypeptide 1 (CYP2E1) gene polymorphisms with acute rejection in kidney transplantation recipients

Kim

Seok

Jeon

et al. 2014

Clinical Transplantation

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Recent studies have shown that single-nucleotide polymorphisms (SNPs) are associated with allograft rejection in kidney transplantation recipients. We evaluated the possible association between SNPs of the cytochrome P450, family 2, subfamily E, polypeptide 1 (CYP2E1) gene, and acute rejection (AR) among renal transplant patients in a Korean population. We conducted a case-control association study in 63 AR and 284 non-AR kidney transplant recipients. The SNPs of CYP2E1 were genotyped by direct sequencing. Recipient sex (p = 0.023) and the use of tacrolimus (p = 0.017) were significantly different between the two groups. The use of mycophenolate mofetil (MMF) and antibody induction therapy was significantly lower in the AR group. Multiple logistic regression models (codominant, dominant, recessive, and log-additive models) adjusted by sex and type of immunosuppressive regimens were applied to determine the odds ratios (ORs), 95% confidence intervals (CIs), and p-values. The rs2515641 of CYP2E1 showed significant differences between the AR patient group and non-AR group (p = 0.003, OR = 2.55, 95% CI = 1.37-4.75 in the codominant 1 model; p = 0.002, OR = 2.61, 95% CI = 1.43-4.77 in the dominant model; p = 0.0035, OR = 2.13, 95% CI = 1.29-3.50 in the log-additive model). The allele of the rs2515641 SNP also showed a significant association (p = 0.004, OR = 1.99, 95% CI = 1.24-3.21). This study suggests that the CYP2E1 polymorphism may be related to the development of AR in Korean kidney transplantation recipients.

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Long-term Outcome of Azathioprine Versus Mycophenolate Mofetil in Cyclosporine-Based Immunosuppression in Kidney Transplantation: 10 Years of Experience at a Single Center

Cited by 7 publications

References 18 publications

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Outcomes of Cadaveric Renal Transplantation Using Mycophenolate Mofetil or Azathioprine in South Africa

Association studies of cytochrome P450, family 2, subfamily E, polypeptide 1 (CYP2E1) gene polymorphisms with acute rejection in kidney transplantation recipients

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