Donor-Specific Anti-Human Leukocyte Antigens Antibodies, Acute Rejection, Renal Function, and Histology in Kidney Transplant Recipients Receiving Tacrolimus and Everolimus

Donor-Specific Anti-Human Leukocyte Antigens Antibodies, Acute Rejection, Renal Function, and Histology in Kidney Transplant Recipients Receiving Tacrolimus and Everolimus

Author Ferreira, Alexandra Nicolau Autor UNIFESP Google Scholar
Felipe, Claudia Rosso Autor UNIFESP Google Scholar
Cristelli, Marina Pontello Autor UNIFESP Google Scholar
Viana, Laila Autor UNIFESP Google Scholar
Basso, Geovana Autor UNIFESP Google Scholar
Autor UNIFESP Google Scholar
Mansur, Juliana Busato Autor UNIFESP Google Scholar
Paula, Mayara Ivani de Autor UNIFESP Google Scholar
Bessa, Adrieli Barros Autor UNIFESP Google Scholar
Ruiz, Priscila Ruppel Autor UNIFESP Google Scholar
Aguiar, Wilson Ferreira Autor UNIFESP Google Scholar
Campos, Erika Fernandes Autor UNIFESP Google Scholar
Gerbase-Lima, Maria Autor UNIFESP Google Scholar
Proença, Henrique Autor UNIFESP Google Scholar
Tedesco-Silva, Helio Autor UNIFESP Google Scholar
Pestana, Jose Osmar Medina Autor UNIFESP Google Scholar
Abstract Background: This analysis compared efficacy, renal function, and histology in kidney transplant recipients receiving tacrolimus (TAC) combined with everolimus (EVR) or mycophenolate (MPS). Methods: This was a retrospective analysis from a randomized trial in kidney transplant recipients who received a single 3 mg/kg dose of rabbit antithymocyte globulin (r-ATG), TAC, EVR, and prednisone (PRED

r-ATG/EVR, n = 85), basiliximab (BAS), TAC, EVR, and PRED (BAS/EVR, n = 102) or BAS, TAC, MPS, and PRED (BAS/MPS, n = 101). We evaluated the incidence of de novo donor-specific anti-human leukocyte antigens antibodies (DSA) and histology on protocol biopsies at 12 months, and the incidence of acute rejection, estimated glomerular filtration rate (eGFR) and proteinuria at 36 months. Results: At 12 months, there were no differences in de novo DSA (6.4 vs. 3.4 vs. 5.5%) or in subclinical inflammation (2.0 vs. 4.8 vs. 10.2%), interstitial fibrosis/tubular atrophy (57.1 vs. 58.5 vs. 53.8%) and C4d deposition (2.0 vs. 7.3 vs. 2.6%). At 36 months, there were no differences in the incidence of treatment failure (19.0 vs. 27.7 vs. 27.7%, p = 0.186), first biopsy-proven acute rejection (9.5 vs. 21.8 vs. 16.8%, p = 0.073), and urine protein/creatinine ratios (0.53 +/- 1.05 vs. 0.62 +/- 0.75 vs. 0.71 +/- 1.24). eGFR was lower in the BAS/EVR compared to that in the BAS/MPS group (53.4 +/- 20.9 vs. 50.8 +/- 19.5 vs. 60.7 +/- 21.2 mL/min/1.73 m(2), p = 0.017) but comparable using a sensitive analysis (49.5 +/- 23 vs. 47.5 +/- 22.6 vs. 53.6 +/- 27.8 mL/min/1.73 m(2), p = 0.207). Conclusion: In this cohort, the use of EVR and reduced TAC concentrations were associated with comparable efficacy, renal function, and histological parameters compared to the standard-of-care immunosuppressive regimen. (C) 2017 S. Karger AG, Basel
Keywords Renal function
Tacrolimus
Everolimus
xmlui.dri2xhtml.METS-1.0.item-coverage Basel
Language English
Sponsor Novartis
Date 2017
Published in American Journal Of Nephrology. Basel, v. 45, n. 6, p. 497-508, 2017.
ISSN 0250-8095 (Sherpa/Romeo, impact factor)
Publisher Karger
Extent 497-508
Origin http://dx.doi.org/10.1159/000475888
Access rights Closed access
Type Article
Web of Science ID WOS:000404361700006
URI https://repositorio.unifesp.br/handle/11600/56265

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account