Alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression.
We performed a pilot study in which 22 kidney recipients (14 LD: 8 DCD) were given alemtuzumab induction (30 mg day 0 and 1), steroids (500 mg mp day 0 and 1, none thereafter), mycophenolate mofetil (MMF) maintenance (500 mg b.i.d) and sirolimus (concentration controlled 8-12 ng/mL). With a mean fol...
| 主要な著者: | , , , , , , , , , , , |
|---|---|
| フォーマット: | Journal article |
| 言語: | English |
| 出版事項: |
2005
|
| _version_ | 1826289925921701888 |
|---|---|
| author | Flechner, S Friend, P Brockmann, J Ismail, H Zilvetti, M Goldfarb, D Modlin, C Mastroianni, B Savas, K Devaney, A Simmonds, M Cook, D |
| author_facet | Flechner, S Friend, P Brockmann, J Ismail, H Zilvetti, M Goldfarb, D Modlin, C Mastroianni, B Savas, K Devaney, A Simmonds, M Cook, D |
| author_sort | Flechner, S |
| collection | OXFORD |
| description | We performed a pilot study in which 22 kidney recipients (14 LD: 8 DCD) were given alemtuzumab induction (30 mg day 0 and 1), steroids (500 mg mp day 0 and 1, none thereafter), mycophenolate mofetil (MMF) maintenance (500 mg b.i.d) and sirolimus (concentration controlled 8-12 ng/mL). With a mean follow-up of 15.9 months, patient survival is (21/22) 96% and graft survival (19/22) 87%. Acute rejections occurred in (8) 36.3% (two humoral). Of 19 surviving grafts, 18 (95%) remain steroid and 15 (79%) CNI-free. At 1 year, mean creatinine was 1.43 mg/dL. Overall infection rates were low, but 2 patients developed severe acute respiratory distress syndrome (ARDS) at month 3 and 7, respectively, resulting in mortality in one and a graft loss in the other. No cancer or PTLD was observed. Leukopenia was common and MMF dose was reduced or eliminated in 6/22 (27%) patients. The reported higher than expected rate of acute rejection, leukopenia and possible pulmonary toxicity suggests excessive morbidity. Modifications such as an initial period of CNI use should be considered. |
| first_indexed | 2024-03-07T02:36:21Z |
| format | Journal article |
| id | oxford-uuid:a8eb26bc-93d6-48e8-94ac-e66e7cbbaacf |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:36:21Z |
| publishDate | 2005 |
| record_format | dspace |
| spelling | oxford-uuid:a8eb26bc-93d6-48e8-94ac-e66e7cbbaacf2022-03-27T03:04:53ZAlemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a8eb26bc-93d6-48e8-94ac-e66e7cbbaacfEnglishSymplectic Elements at Oxford2005Flechner, SFriend, PBrockmann, JIsmail, HZilvetti, MGoldfarb, DModlin, CMastroianni, BSavas, KDevaney, ASimmonds, MCook, DWe performed a pilot study in which 22 kidney recipients (14 LD: 8 DCD) were given alemtuzumab induction (30 mg day 0 and 1), steroids (500 mg mp day 0 and 1, none thereafter), mycophenolate mofetil (MMF) maintenance (500 mg b.i.d) and sirolimus (concentration controlled 8-12 ng/mL). With a mean follow-up of 15.9 months, patient survival is (21/22) 96% and graft survival (19/22) 87%. Acute rejections occurred in (8) 36.3% (two humoral). Of 19 surviving grafts, 18 (95%) remain steroid and 15 (79%) CNI-free. At 1 year, mean creatinine was 1.43 mg/dL. Overall infection rates were low, but 2 patients developed severe acute respiratory distress syndrome (ARDS) at month 3 and 7, respectively, resulting in mortality in one and a graft loss in the other. No cancer or PTLD was observed. Leukopenia was common and MMF dose was reduced or eliminated in 6/22 (27%) patients. The reported higher than expected rate of acute rejection, leukopenia and possible pulmonary toxicity suggests excessive morbidity. Modifications such as an initial period of CNI use should be considered. |
| spellingShingle | Flechner, S Friend, P Brockmann, J Ismail, H Zilvetti, M Goldfarb, D Modlin, C Mastroianni, B Savas, K Devaney, A Simmonds, M Cook, D Alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression. |
| title | Alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression. |
| title_full | Alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression. |
| title_fullStr | Alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression. |
| title_full_unstemmed | Alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression. |
| title_short | Alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for CNI and steroid-free kidney transplant immunosuppression. |
| title_sort | alemtuzumab induction and sirolimus plus mycophenolate mofetil maintenance for cni and steroid free kidney transplant immunosuppression |
| work_keys_str_mv | AT flechners alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT friendp alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT brockmannj alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT ismailh alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT zilvettim alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT goldfarbd alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT modlinc alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT mastroiannib alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT savask alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT devaneya alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT simmondsm alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression AT cookd alemtuzumabinductionandsirolimusplusmycophenolatemofetilmaintenanceforcniandsteroidfreekidneytransplantimmunosuppression |