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Titolo:
MYCOPHENOLATE MOFETIL-BASED, CYCLOSPORINE-FREE INDUCTION AND MAINTENANCE IMMUNOSUPPRESSION - FIRST-3-MONTHS ANALYSIS OF EFFICACY AND SAFETYIN 2 COHORTS OF RENAL-ALLOGRAFT RECIPIENTS
Autore:
ZANKER B; SCHNEEBERGER H; ROTHENPIELER U; HILLEBRAND G; ILLNER WD; THEODORAKIS I; STANGL M; LAND W;
Indirizzi:
KLINIKUM GROSSHADERN,DIV TRANSPLANT SURG,MARCHIONINISTR 15 D-81366 MUNICH GERMANY UNIV MUNICH,KLINIKUM GROSSHADERN,DIV TRANSPLANT SURG D-81377 MUNICH GERMANY
Titolo Testata:
Transplantation
fascicolo: 1, volume: 66, anno: 1998,
pagine: 44 - 49
SICI:
0041-1337(1998)66:1<44:MMCIAM>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSPLANTATION; AZATHIOPRINE; CONVERSION; DIAGNOSIS; AGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
22
Recensione:
Indirizzi per estratti:
Citazione:
B. Zanker et al., "MYCOPHENOLATE MOFETIL-BASED, CYCLOSPORINE-FREE INDUCTION AND MAINTENANCE IMMUNOSUPPRESSION - FIRST-3-MONTHS ANALYSIS OF EFFICACY AND SAFETYIN 2 COHORTS OF RENAL-ALLOGRAFT RECIPIENTS", Transplantation, 66(1), 1998, pp. 44-49

Abstract

Background. The currently used macrolide immunosuppressants, i.e., cyclosporine and tacrolimus, exert considerable nephrotoxicity, We aimedto avoid the nephrotoxic effects by applying a cyclosporine-free regimen for the induction as well as for the maintenance treatment of renal allograft recipients using mycophenolate mofetil (MMF) as the primary immunosuppressant. Methods. Thirteen patients were converted from cyclosporine (CsA) to MMF monotherapy, For 4 weeks, MMF (2 g/day) was added to the CsA treatment, before CsA was tapered by weekly steps of 25mg/day and without ''safeguard treatment'' with additional immunosuppressants, In a second approach, 12 patients older than 50 years, and receiving a renal graft from a donor older than 50 years, were treated primarily with MMF combined with steroids and an induction therapy using antithymocyte globulin, and without the addition of CsA. Results. Thirteen long-term renal transplant patients could be converted from CsA to MMF monotherapy. Conversion resulted in an immediate and long-lasting improvement of their median creatinine values by 20%, No serious adverse events occurred. In the second cohort of 12 patients, MMF was used as the primary immunosuppressant. All patients are alive and no grafts were lost after 4 months (n=12) and after 6 months (n=7). The median creatinine values achieved after 4 and 6 months were 1.16+/-0.25 and 1.30+/-0.21 mg/dl, respectively, One patient was converted to CsA because of a reversible rejection episode (8.3%), and another patient was converted because of cytomegalovirus disease, Major complications consisted of wound-healing disturbances (16.6%) and cytomegalovirus infections (41,6%), Conclusion. MMF monotherapy can be safely applied aslong-term maintenance immunosuppression with improvement of renal function. Steroids are not required as an adjunct to MMF. MMF monotherapy, in the absence of drug-related nephrotoxicity, is particularly beneficial for grafts derived from marginal donors, such as donors of advanced age.

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Documento generato il 02/12/20 alle ore 15:01:20