Andrassy, Joachim and Guba, Markus and Habicht, Antje and Fischereder, Michael and Pratschke, Johann and Pascher, Andreas and Heller, Katharina M. and Banas, Bernhard and Hakenberg, Oliver and Vogel, Thomas and Meiser, Bruno and Dick, Andrea and Werner, Jens and Kauke, Teresa (2020) Early conversion to a CNI-free immunosuppression with SRL after renal transplantation-Long-term follow-up of a multicenter trial. PLOS ONE, 15 (8): e0234396. ISSN 1932-6203,
Full text not available from this repository. (Request a copy)Abstract
Introduction Early conversion to a CNI-free immunosuppression with SRL was associated with an improved 1- and 3- yr renal function as compared with a CsA-based regimen in the SMART-Trial. Mixed results were reported on the occurrence of donor specific antibodies under mTOR-Is. Here, we present long-term results of the SMART-Trial. Methods and materials N = 71 from 6 centers (n = 38 SRL and n = 33 CsA) of the original SMART-Trial (ITT n = 140) were enrolled in this observational, non-interventional extension study to collect retrospectively and prospectively follow-up data for the interval since baseline. Primary objective was the development of dnDSA. Blood samples were collected on average 8.7 years after transplantation. Results Development of dnDSA was not different (SRL 5/38, 13.2% vs. CsA 9/33, 27.3%; P = 0.097). GFR remained improved under SRL with 64.37 ml/min/1.73m(2)vs. 53.19 ml/min/1.73m(2)(p = 0.044). Patient survival did not differ between groups at 10 years. There was a trend towards a reduced graft failure rate (11.6% SRL vs. 23.9% CsA, p = 0.064) and less tumors under SRL (2.6% SRL vs. 15.2% CsA, p = 0.09). Conclusions An early conversion to SRL did not result in an increased incidence of dnDSA nor increased long-term risk for the recipient. Transplant function remains improved with benefits for the graft survival.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | DONOR-SPECIFIC ANTIBODIES; CALCINEURIN INHIBITOR MINIMIZATION; RECIPIENTS RECEIVING TACROLIMUS; PROSPECTIVE RANDOMIZED-TRIAL; HUMAN-LEUKOCYTE ANTIGEN; DE-NOVO SIROLIMUS; KIDNEY-TRANSPLANTATION; MYCOPHENOLATE-MOFETIL; HLA ANTIBODIES; CHRONIC REJECTION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Nephrologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Mar 2021 08:25 |
| Last Modified: | 17 Mar 2021 08:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/44054 |
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