https://scholars.lib.ntu.edu.tw/handle/123456789/521382
標題: | Favorable results of concomitant tacrolimus and sirolimus therapy in Taiwanese renal transplant recipients at 12 months | 作者: | Chen K.-H. MENG-KUN TSAI I-RUE LAI Wu F.-L.L. REY-HENG HU PO-HUANG LEE |
公開日期: | 2008 | 出版社: | Scientific Communications International Ltd | 卷: | 107 | 期: | 7 | 起(迄)頁: | 533-539 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: Combined therapy of sirolimus and cyclosporine has been found to exacerbate cyclosporine-related nephrotoxicity and to imperil graft renal function. We hypothesized that tacrolimus could bring about better renal function than cyclosporine when used in combination with sirolimus and corticosteroids for de novo renal transplantation. Methods: A two-arm randomized study was conducted to test the hypothesis. Patients who gave written informed consent and received renal transplantation were randomized to take sirolimus in combination with either tacrolimus or cyclosporine. The primaiy endpoint of this study was renal function, and the secondary endpoints were acute rejection, graft and patient survival, metabolic side effects and infectious complications. Results: A total of 41 Taiwanese renal transplant patients were randomized to receive cyclosporine (CsA group, n = 20) or tacrolimus (TAC group, n = 21) in combination with sirolimus and corticosteroids. The average estimated glomerular filtration rate (eGFR) was 52.77 ± 3.86 mL per minute for the TAC group at 6 months, and 46.42 ± 3.95 mL per minute for the CsA group (p> 0.05). At 12 months, the average eGFR was 52.04 ± 4.38 mL per minute for the TAC group, and 46.79 ± 4.38 mL per minute for the CsA group (p> 0.05). The biopsy-proven acute rejection rate of the TAC group was 4.76% (1/21), and that of the CsA group was 5.00% (1/20) at 12 months. The 12-month graft survival rates for the TAC and CsA groups were 100% and 90% (p = 0.142), respectively. Conclusion: Our study demonstrated that concomitant tacrolimus and sirolimus therapy resulted in a favorable outcome in Taiwanese renal transplant patients at 12 months. Large-scale clinical trials will be needed to further address the issue of which calcineurin inhibitor, cyclosporine or tacrolimus, provides better renal function and graft survival for renal transplant patients. ?2008 Elsevier & Formosan Medical Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-50049123618&doi=10.1016%2fS0929-6646%2808%2960166-7&partnerID=40&md5=89e8f0f8215d07bb5aac946e0727e766 https://scholars.lib.ntu.edu.tw/handle/123456789/521382 |
ISSN: | 0929-6646 | DOI: | 10.1016/S0929-6646(08)60166-7 | SDG/關鍵字: | cholesterol; corticosteroid; cyclosporin A; fibric acid derivative; HLA antigen; hydroxymethylglutaryl coenzyme A reductase inhibitor; insulin; rapamycin; tacrolimus; valganciclovir; acute graft rejection; adult; alanine aminotransferase blood level; article; aspartate aminotransferase blood level; bacterial pneumonia; clinical article; clinical trial; controlled clinical trial; controlled study; Cytomegalovirus; deep vein thrombosis; diabetes mellitus; drug blood level; drug substitution; drug withdrawal; female; glomerulus filtration rate; graft failure; graft infection; graft recipient; graft survival; hemolytic uremic syndrome; hirsutism; HLA matching; human; hypercholesterolemia; hyperlipidemia; hypothesis; informed consent; kidney biopsy; kidney failure; kidney function; kidney graft; kidney graft rejection; kidney transplantation; Legionella; loading drug dose; male; medical research; outcome assessment; peritoneal dialysis; peritonitis; pyrexia idiopathica; randomized controlled trial; rapidly progressive glomerulonephritis; side effect; Taiwan; treatment outcome; urinary tract infection; urine incontinence |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。