Abstract
We evaluated outcomes with the sirolimus (SRL) and mycophenolate mofetil (MMF) combination regimen (SRL/MMF) in solitary kidney transplant recipients transplanted between 2000 and 2005 reported to the Scientific Registry of Renal Transplant Recipients. Three-and-a-half percent received SRL/MMF (n = 2040). Six-month acute rejection rates were higher with SRL/MMF (SRL/MMF: 16.0% vs. other regimens: 11.2%, p < 0.001). Overall graft survival was significantly lower on SRL/MMF. SRL/MMF was associated with twice the hazard for graft loss (AHR = 2.0, 95% C.I., 1.8, 2.2) relative to TAC/MMF, also consistent in both living donor transplants (AHR = 2.4, 95% C.I., 1.9, 2.9) and expanded criteria donor transplants (AHR = 2.1, 95% C.I., 1.7-2.5). Among deceased donor transplants, DGF rates were higher in the SRL/MMF cohort (47% vs. 27%, p < 0.001). However, adjusted graft survival was also significantly inferior with SRL/MMF in DGF-free patients (AHR = 1.9, 95% C.I., 1.6-2.3). In analyses restricted to patients who remained on the discharge regimen at 6 months posttransplant, conditional graft survival in deceased donor transplants was significantly lower with SRL/MMF compared to patients on TAC/MMF or CsA/MMF regimens at 5 years posttransplant (64%, 78%, 78%, respectively, p = 0.001) and across all patient subgroups. In conclusion, SRL/MMF is associated with inferior renal transplant outcomes compared with other commonly used regimens.
| Original language | English |
|---|---|
| Pages (from-to) | 586-594 |
| Number of pages | 9 |
| Journal | American Journal of Transplantation |
| Volume | 7 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2007 |
| Externally published | Yes |
Fingerprint
Keywords
- Calcium inhibitor
- Cyclosporin
- M-TOR inhibitor
- Mycophenolate mofetil
- Rapamycin
- Tacrolimus
ASJC Scopus subject areas
- Immunology
Cite this
Mycophenolate mofetil/sirolimus compared to other common immunosuppressive regimens in kidney transplantation. / Srinivas, T. R.; Schold, J. D.; Guerra, Giselle; Eagan, A.; Bucci, C. M.; Meier-Kriesche, H. U.
In: American Journal of Transplantation, Vol. 7, No. 3, 01.03.2007, p. 586-594.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Mycophenolate mofetil/sirolimus compared to other common immunosuppressive regimens in kidney transplantation
AU - Srinivas, T. R.
AU - Schold, J. D.
AU - Guerra, Giselle
AU - Eagan, A.
AU - Bucci, C. M.
AU - Meier-Kriesche, H. U.
PY - 2007/3/1
Y1 - 2007/3/1
N2 - We evaluated outcomes with the sirolimus (SRL) and mycophenolate mofetil (MMF) combination regimen (SRL/MMF) in solitary kidney transplant recipients transplanted between 2000 and 2005 reported to the Scientific Registry of Renal Transplant Recipients. Three-and-a-half percent received SRL/MMF (n = 2040). Six-month acute rejection rates were higher with SRL/MMF (SRL/MMF: 16.0% vs. other regimens: 11.2%, p < 0.001). Overall graft survival was significantly lower on SRL/MMF. SRL/MMF was associated with twice the hazard for graft loss (AHR = 2.0, 95% C.I., 1.8, 2.2) relative to TAC/MMF, also consistent in both living donor transplants (AHR = 2.4, 95% C.I., 1.9, 2.9) and expanded criteria donor transplants (AHR = 2.1, 95% C.I., 1.7-2.5). Among deceased donor transplants, DGF rates were higher in the SRL/MMF cohort (47% vs. 27%, p < 0.001). However, adjusted graft survival was also significantly inferior with SRL/MMF in DGF-free patients (AHR = 1.9, 95% C.I., 1.6-2.3). In analyses restricted to patients who remained on the discharge regimen at 6 months posttransplant, conditional graft survival in deceased donor transplants was significantly lower with SRL/MMF compared to patients on TAC/MMF or CsA/MMF regimens at 5 years posttransplant (64%, 78%, 78%, respectively, p = 0.001) and across all patient subgroups. In conclusion, SRL/MMF is associated with inferior renal transplant outcomes compared with other commonly used regimens.
AB - We evaluated outcomes with the sirolimus (SRL) and mycophenolate mofetil (MMF) combination regimen (SRL/MMF) in solitary kidney transplant recipients transplanted between 2000 and 2005 reported to the Scientific Registry of Renal Transplant Recipients. Three-and-a-half percent received SRL/MMF (n = 2040). Six-month acute rejection rates were higher with SRL/MMF (SRL/MMF: 16.0% vs. other regimens: 11.2%, p < 0.001). Overall graft survival was significantly lower on SRL/MMF. SRL/MMF was associated with twice the hazard for graft loss (AHR = 2.0, 95% C.I., 1.8, 2.2) relative to TAC/MMF, also consistent in both living donor transplants (AHR = 2.4, 95% C.I., 1.9, 2.9) and expanded criteria donor transplants (AHR = 2.1, 95% C.I., 1.7-2.5). Among deceased donor transplants, DGF rates were higher in the SRL/MMF cohort (47% vs. 27%, p < 0.001). However, adjusted graft survival was also significantly inferior with SRL/MMF in DGF-free patients (AHR = 1.9, 95% C.I., 1.6-2.3). In analyses restricted to patients who remained on the discharge regimen at 6 months posttransplant, conditional graft survival in deceased donor transplants was significantly lower with SRL/MMF compared to patients on TAC/MMF or CsA/MMF regimens at 5 years posttransplant (64%, 78%, 78%, respectively, p = 0.001) and across all patient subgroups. In conclusion, SRL/MMF is associated with inferior renal transplant outcomes compared with other commonly used regimens.
KW - Calcium inhibitor
KW - Cyclosporin
KW - M-TOR inhibitor
KW - Mycophenolate mofetil
KW - Rapamycin
KW - Tacrolimus
UR - http://www.scopus.com/inward/record.url?scp=33847717932&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33847717932&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2006.01658.x
DO - 10.1111/j.1600-6143.2006.01658.x
M3 - Article
VL - 7
SP - 586
EP - 594
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 3
ER -