Primary immunosuppression with tacrolimus and mycophenolate mofetil for renal allograft recipients

David Roth, Jane Colona, George W Burke, Gaetano Ciancio, Violet Esquenazi, Joshua Miller

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Background. Studies using tacrolimus and corticosteroids or the combination of cyclosporine, mycophenolate mofetil, and corticosteroids have been shown to reduce the incidence of biopsy-proven acute rejection episodes in cadaveric kidney recipients compared with cyclosporine-based immunosuppresion. The current study is a retrospective analysis of our experience with tacrolimus combined with mycophenolate mofetil and steroids as primary immunosuppression for kidney transplant recipients. Methods. In a retrospective analysis, 72 patients who received primary therapy with tacrolimus, mycophenolate mofetil, and corticosteroids (triple therapy) were compared with a control group of 98 kidney recipients who received tacrolimus and corticosteroids (double therapy). Results. There was a significant reduction in the incidence of biopsy-confirmed acute rejection in the triple therapy group (8.2%) compared with the double therapy group (21%; P=0.003). One-year patient and graft survival did not differ between groups. The incidence of posttransplant diabetes mellitus was 18% and 21% in the triple and double therapy groups, respectively. Leukopenia and gastrointestinal side effects were the most common cause for discontinuation of mycophenolate mofetil. Conclusions. The combination of tacrolimus with mycophenolate mofetil and corticosteroids is more effective at preventing early acute rejection than tacrolimus and corticosteroids alone. The use of mycophenolate mofetil was associated with a higher incidence of leukopenia and diarrhea, often leading to discontinuation of the drug.

Original languageEnglish
Pages (from-to)248-252
Number of pages5
JournalTransplantation
Volume65
Issue number2
StatePublished - Jan 27 1998

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Mycophenolic Acid
Tacrolimus
Immunosuppression
Allografts
Adrenal Cortex Hormones
Kidney
Group Psychotherapy
Incidence
Leukopenia
Cyclosporine
Biopsy
Graft Survival
Diarrhea
Diabetes Mellitus
Therapeutics
Steroids
Control Groups
Pharmaceutical Preparations
Rejection (Psychology)

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Primary immunosuppression with tacrolimus and mycophenolate mofetil for renal allograft recipients. / Roth, David; Colona, Jane; Burke, George W; Ciancio, Gaetano; Esquenazi, Violet; Miller, Joshua.

In: Transplantation, Vol. 65, No. 2, 27.01.1998, p. 248-252.

Research output: Contribution to journalArticle

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abstract = "Background. Studies using tacrolimus and corticosteroids or the combination of cyclosporine, mycophenolate mofetil, and corticosteroids have been shown to reduce the incidence of biopsy-proven acute rejection episodes in cadaveric kidney recipients compared with cyclosporine-based immunosuppresion. The current study is a retrospective analysis of our experience with tacrolimus combined with mycophenolate mofetil and steroids as primary immunosuppression for kidney transplant recipients. Methods. In a retrospective analysis, 72 patients who received primary therapy with tacrolimus, mycophenolate mofetil, and corticosteroids (triple therapy) were compared with a control group of 98 kidney recipients who received tacrolimus and corticosteroids (double therapy). Results. There was a significant reduction in the incidence of biopsy-confirmed acute rejection in the triple therapy group (8.2{\%}) compared with the double therapy group (21{\%}; P=0.003). One-year patient and graft survival did not differ between groups. The incidence of posttransplant diabetes mellitus was 18{\%} and 21{\%} in the triple and double therapy groups, respectively. Leukopenia and gastrointestinal side effects were the most common cause for discontinuation of mycophenolate mofetil. Conclusions. The combination of tacrolimus with mycophenolate mofetil and corticosteroids is more effective at preventing early acute rejection than tacrolimus and corticosteroids alone. The use of mycophenolate mofetil was associated with a higher incidence of leukopenia and diarrhea, often leading to discontinuation of the drug.",
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