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Titolo:
Long-term results of a randomized study comparing three immunosuppressive schedules with cyclosporine in cadaveric kidney transplantation
Autore:
Montagnino, G; Tarantino, A; Segoloni, GP; Cambi, V; Rizzo, G; Altieri, P; Castagneto, M; Salvadori, M; Cossu, M; Pisani, F; Carmellini, M; Mastrangelo, F; Ferrara, R; Ponticelli, C;
Indirizzi:
IRCCS, Osped Maggiore, Div Nefrol & Dialisi, I-20122 Milan, Italy IRCCS Milan Italy I-20122 re, Div Nefrol & Dialisi, I-20122 Milan, Italy AOS Giovanni Battista, Div Nefrol & Dialisi, Turin, Italy AOS Giovanni Battista Turin Italy a, Div Nefrol & Dialisi, Turin, Italy Univ Parma, Cattedra Nefrol, I-43100 Parma, Italy Univ Parma Parma ItalyI-43100 ma, Cattedra Nefrol, I-43100 Parma, Italy Osped S Chiara, UO Nefrol & Trapianti, Pisa, Italy Osped S Chiara Pisa Italy S Chiara, UO Nefrol & Trapianti, Pisa, Italy Osped Brotzu, Div Nefrol & Dialisi, Cagliari, Italy Osped Brotzu Cagliari Italy otzu, Div Nefrol & Dialisi, Cagliari, Italy Univ Cattolica, Cattedra Chirurgia Sostitutiva & Trapianto Dorgan, Rome, Italy Univ Cattolica Rome Italy a Sostitutiva & Trapianto Dorgan, Rome, Italy Policlin Careggi, Div Nefrol & Dialisi, Florence, Italy Policlin Careggi Florence Italy , Div Nefrol & Dialisi, Florence, Italy Osped Civile, Div Nefrol & Dialisi, Sassari, Italy Osped Civile Sassari Italy Civile, Div Nefrol & Dialisi, Sassari, Italy Osped S Eugenio, Div Clin Chirurgica, Rome, Italy Osped S Eugenio Rome Italy S Eugenio, Div Clin Chirurgica, Rome, Italy Univ Siena, Inst Sci Chirurg, I-53100 Siena, Italy Univ Siena Siena Italy I-53100 a, Inst Sci Chirurg, I-53100 Siena, Italy Osped Fazzi, Div Nefrol & Dialisi, Lecce, Italy Osped Fazzi Lecce ItalyOsped Fazzi, Div Nefrol & Dialisi, Lecce, Italy Novartis Farma SpA, Origgio, Italy Novartis Farma SpA Origgio ItalyNovartis Farma SpA, Origgio, Italy Univ Roma Tor Vergata, Rome, Italy Univ Roma Tor Vergata Rome ItalyUniv Roma Tor Vergata, Rome, Italy
Titolo Testata:
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
fascicolo: 10, volume: 12, anno: 2001,
pagine: 2163 - 2169
SICI:
1046-6673(200110)12:10<2163:LROARS>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
RENAL-TRANSPLANTATION; RISK-FACTORS; ALLOGRAFT SURVIVAL; CONTROLLED TRIAL; RECIPIENTS; REJECTION; STEROIDS; THERAPY; AZATHIOPRINE; MONOTHERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Montagnino, G IRCCS, Osped Maggiore, Div Nefrol & Dialisi, Via Commenda 15, I-20122 Milan, Italy IRCCS Via Commenda 15 Milan Italy I-20122 0122 Milan, Italy
Citazione:
G. Montagnino et al., "Long-term results of a randomized study comparing three immunosuppressive schedules with cyclosporine in cadaveric kidney transplantation", J AM S NEPH, 12(10), 2001, pp. 2163-2169

Abstract

In this randomized controlled trial started in October 1990, 354 cadaverickidney transplant recipients were assigned to receive either cyclosporine (CsA) monotherapy (115 patients), CsA + steroids (117 patients), or CsA + steroids + azathioprine (122 patients). The median follow-up was 85.1 mo. Thirty-one deaths occurred (infection, 12; cardiovascular disease, 11; neoplasia, 4; and others, 4), and 65 grafts were lost, mostly due to acute (15) or chronic rejection (50). The cumulative graft half-life was 18.1 yr. According to the "intention-to-treat," the 9-yr actuarial patient and graft survival were 94.0% and 73.3%, respectively, in monotherapy. 87.3% and 65.9% indual therapy, and 87% and 72.2% in triple therapy (P=0.647). At the last follow-up, the percentage of patients who remained with the original treatment was 51.2% in monotherapy, 81.7% in dual therapy, and 63.3% in triple therapy. At the seventh year, the mean creatinine clearances were 54.9 +/- 17.6 ml/min in monotherapy, 57.9 +/- 23.4 in dual therapy, and 60.6 +/- 20.7 in triple therapy (P=0.375). Cataracts (P=0.000), osteoporosis (P=0.000). and cardiovascular complications (P=0.000) were more frequent in dual or triple therapy than in monotherapy. Actuarial graft survival at 9 yr in patients on monotherapy who had to have steroids added was similar to that of the other two groups (62.2% versus 69.3%, P=0.134). In conclusion, actuarial patient and graft survivals did not differ among the three schemes. The long-term renal function and survival were not affected in the patients on monotherapy who needed the addition of steroids. Monotherapy was associated witha lower incidence of extrarenal complications than the other two regimens.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 00:14:03