References of "Squifflet, Jean-Paul"
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See detailDaclizumab versus rabbit antithymocyte globulin in high-risk renal tranplants : five-year follow-up of a randomized study
Hellemans, R; Hazzan, M; Durand, D et al

in American Journal of Transplantation (2015), 15

Acute rejection after kidney transplantation is a major cause of allograft dysfunction and can lead to rapid loss of graft function despite anti-rejection therapy. Even when kidney function initially ... [more ▼]

Acute rejection after kidney transplantation is a major cause of allograft dysfunction and can lead to rapid loss of graft function despite anti-rejection therapy. Even when kidney function initially recovers, acute rejection is associated with an increased risk of long-term graft failure (1). Acute rejection is, accordingly, a well-established surrogate endpoint for long-term outcomes. High-quality evidence has shown that induction therapy with a biological agent lowers the risk of acute rejection, and it is therefore widely administered as part of the early immunosuppressive regimen (2,3). In recipients at low immunological risk (i.e. patients with no previous exposure to human leukocyte antigens [HLA]) either lymphocyte-depleting polyclonal [less ▲]

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See detailEuropean Renal Best Practice Guideline on kidney donor and recipient evaluation and perioperative care
Abramowicz, Daniel; Cochat, Pierre; Claas, Frans H.J et al

in Nephrology Dialysis Transplantation (2014)

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See detailGuías Europeas sobre manejo y evaluación de receptores y donantes renales
Pascual, Julio; Abramowicz, Daniel; Cochat, Pierre et al

in Nefrologia : Publicacion Oficial de la Sociedad Espanola Nefrologia (2014), 34(3), 293-301

El objetivo de esta guía de práctica clínica es ofrecer orientación para la evaluación tanto del donante como del receptor del trasplante de riñón y para el manejo del receptor durante el período ... [more ▼]

El objetivo de esta guía de práctica clínica es ofrecer orientación para la evaluación tanto del donante como del receptor del trasplante de riñón y para el manejo del receptor durante el período perioperatorio. Ha sido diseñada para informar y asistir en la toma de decisiones. En ningún caso pretende definir una norma asistencial ni su carácter debe concebirse como tal ni interpretarse como prescriptivo de un manejo exclusivo. La versión original de esta guía fue publicada en la revista Nephrology, Dialysis and Transplantation. Esta versión reducida pretende colaborar en la divulgación de esta guía en los países y las comunidades trasplantadoras hispanohablantes. [less ▲]

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See detailA More Than 20% Increase in Deceased-Donor Organ Procurement and Transplantation Activity After the Use of Donation After Circulatory Death.
Le Dinh, H.; MONARD, Josée ULg; DELBOUILLE, Marie-Hélène ULg et al

in Transplantation proceedings (2014), 46(1), 9-13

BACKGROUND: Organ procurement and transplant activity from controlled donation after circulatory death (DCD) was evaluated over an 11-year period to determine whether this program influenced the ... [more ▼]

BACKGROUND: Organ procurement and transplant activity from controlled donation after circulatory death (DCD) was evaluated over an 11-year period to determine whether this program influenced the transplant and donation after brain death (DBD) activities. MATERIAL AND METHODS: Deceased donor (DD) procurement and transplant data were prospectively collected in a local database for retrospective review. RESULTS: There was an increasing trend in the potential and actual DCD numbers over time. DCD accounted for 21.9% of the DD pool over 11 years, representing 23.7% and 24.2% of the DD kidney and liver pool, respectively. The DBD retrieval and transplant activity increased during the same time period. Mean conversion rate turning potential into effective DCD donors was 47.3%. Mean DCD donor age was 54.6 years (range, 3-83). Donors >/=60 years old made up 44.1% of the DCD pool. Among referred donors, reasons for nondonation were medical contraindications (33.7%) and family refusals (19%). Mean organ yield per DCD donor was 2.3 organs. Mean total procurement warm ischemia time was 19.5 minutes (range, 6-39). In 2012, 17 DCD and 37 DBD procurements were performed in the Liege region, which has slightly >1 million inhabitants. CONCLUSIONS: This DCD program implementation enlarged the DD pool and did not compromise the development of DBD programs. The potential DCD pool might be underused and seems to be a valuable organ donor source. [less ▲]

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See detailERBP Doporučené postupy při posuzování dárců a příjemců pro transplantaci ledviny a v perioperační péči
Abramowicz, D; Cochat, P; Claas, F et al

in Aktuality v Nefrologii (2014), 20(2), 78-85

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See detailDONATION AFTER CIRCULATORY DEATH INCREASES THE CADAVERIC DONOR POOL
Le Dinh, H.; DE ROOVER, Arnaud ULg; SQUIFFLET, Jean-Paul ULg et al

in Transplant International (2013, December), 26(S2), 54-101

Background: There is a controversy on the possibility to increase the organ donor pool by donation-after-circulatory-death (DCD) and the possible decrease in donation-after-brain-death (DBD) by DCD ... [more ▼]

Background: There is a controversy on the possibility to increase the organ donor pool by donation-after-circulatory-death (DCD) and the possible decrease in donation-after-brain-death (DBD) by DCD programs. Our aim is to report the DCD experience at the University Hospital of Liege, Belgium, from 2002 through 2012, in a donor region of about 1 million inhabitants. Methods: The prospective organ donor and recipient databases were retrospectively reviewed. Results: 94 and 331 procurements were performed from controlled DCD and DBD donors in the time period, respectively. DCD donors contributed to 22.1% of the deceased donor (DD) organ procurement activity from Jan 2002 to Dec 2012, and up to one-third annually since 2009. DCD liver and kidneys contributed 23.7% and 24.2% of the DD liver and kidney transplantation activity, respectively. There was no decrease of the DBD procurement in the study period. In 2012, overall 54 DD were procured in the Liege region, reaching a high procurement activity.Conclusions: Controlled DCD donors are a valuable source of transplantable liver and kidney grafts, and in our experience do not adversely affect DBD organ procurement activity. [less ▲]

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See detailINFUSION OF THIRD-PARTY MESENCHYMAL STEM CELLS (MSC) AFTER KIDNEY AND LIVER TRANSPLANTATION: A PHASE I-II, OPEN-LABEL, CLINICAL STUDY (EudraCT 2011-001822-81 & NCT01429038)
DETRY, Olivier ULg; DELBOUILLE, Marie-Hélène ULg; LECHANTEUR, Chantal ULg et al

Poster (2013, May 30)

MSC cells have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aims to be the first evaluation of the safety and tolerability of third party MSC ... [more ▼]

MSC cells have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aims to be the first evaluation of the safety and tolerability of third party MSC infusion after cadaveric kidney and liver transplantation in a prospective phase I-II study, taking advantage of our centre expertise and experience in MSC use in graft-versus-host disease (GVHD) after bone marrow transplantation and using an already functioning GMP-compliant laboratory producing clinical-grade MSC. Secondary end-points will help to evaluate the immunosuppressive potential of MSC after organ transplantation, and the opportunity to develop larger randomised, controlled, phase III trials. After successful transplantation, 10 liver and 10 kidney transplant recipients under standard immunosuppression (tacrolimus, MMF, steroids) will receive an intravenous infusion of 1.5-3x106/kg of third-party MSC on post-operative day 3±2. These patients will be prospectively compared to 10 liver and 10 kidney recipients who meet the inclusion criteria but deny MSC infusion. Safety will be assessed by recording side effects, including opportunistic infections and cancers. Immunosuppressive potential will be evaluated by rejection episode rates, by graft/patient survivals, by immunohistology of 3-months kidney and 6-month liver graft biopsies and by in vitro evaluation of the immunity profile of the recipients. In a second step, reduction (kidney) and progressive weaning (liver) of immunosuppression will be attempted in recipients who received MSC. This ongoing study is supported by research grants from the CHU of Liège, University of Liège, and by the Senior Clinical Research Grant from ESOT. The first patients were included and treated in early 2012, and final results expected in late 2013. [less ▲]

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See detailKidney and Pancreas Transplantation : The history of Surgical Techniques and immunosuppression
SQUIFFLET, Jean-Paul ULg

in current issues and future direction in kidney transplantation (2013)

Pancreas Transplantation aims at providing Beta cells replacement in diabetic patients, especially for type 1 diabetes recipients in whom Beta cells had been destroyed by an autoimmune process. The final ... [more ▼]

Pancreas Transplantation aims at providing Beta cells replacement in diabetic patients, especially for type 1 diabetes recipients in whom Beta cells had been destroyed by an autoimmune process. The final achievement is to restore a normal physiological control of glucose metabolism in order to halt or reverse the secondary complications of diabetes i.e. retinopathy, neuropathy, nephropathy, micro – and macro - angiopathy [1]. That can be achieved by a vascularised pancreas graft (referred as Pancreas Transplantation, PT) or by islet grafting (referred as Islet Transplantation, IT). The former PT includes transplanting 95% of unuseful cells, the exocrine part from one pancreas, while the last one IP, embolizing into the recipient liver, Islets of Langerhans after digestion and purification of several human pancreases. Three types of PT can be performed: the pancreas and a kidney are simultaneously transplanted with a single induction of immunosuppression (IS) therapy in hoping to correct both uremia and diabetes mellitus (SPK = Simultaneous Pancreas and Kidney Transplantation); the pancreas is transplanted after a successful kidney graft allowing two induction therapies along with the basic IS treatment (PAK = Pancreas After Kidney Transplantation) ; and finally the Pancreas can be transplanted alone in pre-uremic recipients with unawareness hypoglycaemic events or with rapidly evolving secondary complications of diabetes such as proliferative retinopathy, or advanced neuropathy (PTA = Pancreas Transplantation Alone) [1]. Moreover, in SPK, both organs the Pancreas and the Kidney are procured from the same deceased donor, either donor after brain death (DBD) or donor after cardiac death (DCD). In some US institutions, a segmental pancreas and the left kidney, are procured in a living donor [2], using a laparoscopic approach in the more recent year [3]. For PAK, in order to avoid an excessive IS load and two induction therapies, other institutions had proposed whenever possible to keep in stand-by the potential live kidney donor until a cadaver whole pancreatic compatible graft is available [1]. By contrast, the number of PTA remains limited in non uremic recipients with life-threatening complications of diabetes, in whom one might hope to avoid the hypoglycaemic events with a successful graft. That can also be achieved with IT. But except for rare cases, insulin independence with IT requires more than a single human pancreas and is limited over time [1]. Moreover, IT needs costly materials, chambers and rooms for preparation. That’s why IT will not be included in the present report. [less ▲]

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See detailPurpose and scope
Abramowucz, Daniel; Cochat, Pierre; Claas, Frans et al

in Nephrology Dialysis Transplantation (2013), 28

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See detailA comparative, Randomized trial of Concentration-Controlled Sirolimus Combined With Reduced-Dose Tacrolimus or Standard-Dose Tacrolimus in Renal Allograft Recipients
Bechstein, W.O; Paczeck, L; Wramner, L et al

in Transplantation Proceedings (2013), 45

The clinical safety and efficacy of sirolimus plus reduced-dose tacrolimus was evaluated in de novo renal allograft recipients enrolled in a comparative, open-label study. Methods. One hundred twenty ... [more ▼]

The clinical safety and efficacy of sirolimus plus reduced-dose tacrolimus was evaluated in de novo renal allograft recipients enrolled in a comparative, open-label study. Methods. One hundred twenty-eight renal allograft recipients were randomly assigned (1:1) to receive reduced-dose tacrolimus plus sirolimus (rTAC) or standard-dose tacrolimus and sirolimus (sTAC) for 6 months. The primary efficacy endpoint was calculated creatinine clearance values at 6 months. Results. Demographic variables were similar between groups. At 6 months, mean ( standard deviation) calculated creatinine clearance was significantly improved in the rTAC group (63.8 vs 52.7 mL/min, P ¼ .005), although mean serum creatinine values were not significantly different. Patient survival (95.2% and 96.9%) and graft survival (93.7% and 98.5%) were similar between the rTAC and sTAC groups, respectively. Acute rejection rates were 17.5% with rTAC and 7.7% with sTAC (P ¼ .095). Conclusions. The rTAC regimen provided effective immunosuppression and was associated with improved creatinine clearance. Adequate immunosuppressant exposure must be achieved in the early postoperative period to minimize the risk of acute rejection. [less ▲]

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See detailTacrolimus-Based, Steroid-Free Regimens in Renal Transplantation: 3-year Follow-up of the ATLAS Trial
Krämer, Bernhard k; Klinger, Marian; Vitko, Stefan et al

in Transplantation (2012), 94(5), 492-498

Background. Long-term use of corticosteroids is associated with considerable morbidity, including cardiovascular and metabolic adverse effects. Methods. This study evaluated the long-term efficacy and ... [more ▼]

Background. Long-term use of corticosteroids is associated with considerable morbidity, including cardiovascular and metabolic adverse effects. Methods. This study evaluated the long-term efficacy and safety of two steroid-free regimens compared with a triple immunosuppressive therapy in renal transplant recipients. This was a 3-year follow-up to a 6-month, open-label, randomized, multicenter study. Results. Data from 3 years were available for 421 (93.3%) of 451 patients in the original intent-to-treat population (143 tacrolimus/basiliximab [Tac/Bas], 139 tacrolimus/mycophenolate mofetil [Tac/MMF], and 139 tacrolimus/MMF/ [less ▲]

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See detailCategories of donation after cardiocirculatory death.
DETRY, Olivier ULg; Le Dinh, Hieu ULg; NOTERDAEME, Timothée et al

in Transplantation Proceedings (2012), 44(5), 1189-95

The interest in donation after cardiocirculatory death (DCD) was renewed in the early 1990s, as a means to partially overcome the shortage of donations after brain death. In some European countries and in ... [more ▼]

The interest in donation after cardiocirculatory death (DCD) was renewed in the early 1990s, as a means to partially overcome the shortage of donations after brain death. In some European countries and in the United States, DCD has become an increasingly frequent procedure over the last decade. To improve the results of DCD transplantation, it is important to compare practices, experiences, and results of various teams involved in this field. It is therefore crucial to accurately define the different types of DCD. However, in the literature, various DCD terminologies and classifications have been used, rendering it difficult to compare reported experiences. The authors have presented herein an overview of the various DCD descriptions in the literature, and have proposed an adapted DCD classification to better define the DCD processes, seeking to provide a better tool to compare the results of published reports and to improve current practices. This modified classification may be modified in the future according to ongoing experiences in this field. [less ▲]

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See detailLiège experience in donation after cardiac death liver transplantation: 2003-2011
Le Dinh, Hieu ULg; DELWAIDE, Jean ULg; MONARD, Josée ULg et al

in Acta Chirurgica Belgica (2012, May), 112(3), 6811

Objectives: Results of DCD-LT at the University Hospital of Liège were evaluated from 2003 to 2011. Methods: Medical records of 56 DCD liver recipients were retrospectively reviewed with regard to patient ... [more ▼]

Objectives: Results of DCD-LT at the University Hospital of Liège were evaluated from 2003 to 2011. Methods: Medical records of 56 DCD liver recipients were retrospectively reviewed with regard to patient and graft survivals and biliary complications. Mean follow-up was 26.4 months. Mean donor age was 56.3±14.5 years (25 - 83). Donor causes of death were due to anoxia (51.8%), stroke (32.1%) and head trauma (14.3%). Mean WIT, CIT and suture time were 20.5±7.1min (10 – 39), 265.6±85.1min (105 – 576), and 40.8±7.8 min (25 – 61), respectively. 95% of liver grafts were locally shared. HTK was the most commonly used perfusion solution (86%). Mean recipient age was 56.6±10.5 years (29 – 73). Indications for LT included ESLD (53.6%) and HCC (46.6%). Mean MELD score at transplant was 15.6±6.1points (6 – 40). Results: No primary non-function grafts. Mean peak serum AST and bilirubin levels were 2520±3621UI/L and 50.2±49.2mg/L, respectively. Eight patients (14.3%) developed biliary complications. No intra-hepatic bile duct strictures or re-transplantation. Global patient and graft survival was 92.6% at 3 months, 92.6% at 1 year, 73.8% at 3 years and 60% at 5 years. Death-censored patient and graft survival at the corresponding time points was 92.6%, 92.6%, 87.7% and 87.7%. Thirteen liver grafts were lost during follow-up exclusively due to recipient deaths. The rate of HCC recurrence was 33.3%. Conclusions: Controlled DCD donors are a valuable source of transplantable liver grafts. Primary results are encouraging and apparently as good as those from brain-dead donation LT essentially due to short WIT and CIT. [less ▲]

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See detailResults of kidney transplantation from controlled donors after cardio-circulatory death: a single center experience
Le Dinh, Hieu ULg; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

in Acta Chirurgica Belgica (2012, May), 112(3), 667

Objectives: The aim of this study was to determine results of kidney transplantation (KT) from controlled donation after cardio-circulatory death (DCD). Primary end-points were graft and patient survival ... [more ▼]

Objectives: The aim of this study was to determine results of kidney transplantation (KT) from controlled donation after cardio-circulatory death (DCD). Primary end-points were graft and patient survival, and post-transplant complications. The influence of delayed graft function (DGF) on graft survival and DGF risk factors were analyzed as secondary end-points. Methods: This is a retrospective mono-center review of a consecutive series of 80 DCD-KT performed at the University Hospital of Sart Tilman, University of Liège, between Jan 2005 and Dec 2011. Mean patient follow-up was 28.5 months. Results: Overall graft survival was 93.7%, 89.5%, 85% and 81.3% at 3 months, 1 year, 3 and 5 years, respectively. Death-censored graft survival at the corresponding time points was 93.7%, 93.7%, 90.8% and 90.8%. Main cause of graft loss was patient’s death with a functioning graft. No primary non-function grafts were encountered. Renal graft function was suboptimal at hospital discharge, but nearly normalized at 3 months. DGF was observed in 36% of all DCD-KT. DGF significantly increased post-operative length of hospitalization, but had no deleterious impact on graft function or survival. Donor body mass index (BMI) ≥30 kg/m2, recipient BMI ≥30 kg/m2 and pre-transplant dialysis duration significantly increased the risk of DGF in a multivariate logistic regression analysis (p < 0.05). Conclusions: Despite a higher rate of DGF, controlled DCD-KT offers a valuable contribution to the pool of deceased donor kidney grafts, with comparable mid-term results to those procured after brain death. [less ▲]

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See detailDelayed graft function does not harm the future of donation-after- cardiac-death kidney transplants
LeDinh, H; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

Conference (2012, March 29)

Introduction: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of ... [more ▼]

Introduction: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of DGF on post-transplant outcomes in controlled DCD kidney grafts. Patients and Methods: This single-center retrospective study recruited 80 controlled DCD kidney allo- grafts which have been performed at the University Hospital of Sart Tilman, University of Liège, from Jan 2005 to Dec 2011. Results: Mean patient follow-up was 28.5 months. No primary non-function grafts were encountered. DGF rate was 36%. Overall graft survivals between groups with and without DGF were 92.4% and 95.1% at 1 year, 92.4% and 91.7% at 3 years, and 84.7% and 91.7% at 5 years (p=ns), respectively. Patients with and without DGF had the same survival rates at the corresponding time points (92.4% and 97.1%, 92.4% and 93.7%, and 84.7% and 93.7%, p=ns, respectively). Estimated glomerular filtration rate (eGFR) was significantly lower in DGF group compared to non-DGF group at hospital discharge (29 vs 42 ml/min, p=0.001) and up to 1 year post-transplant (46 vs 53 ml/min, p=0.045), but the differ- ence disappeared afterwards (50 vs 48 ml/min at 3 years, and 54 vs 53 ml/min at 5 years, p=ns). DGF did not increase the risk of acute rejection or surgical complications. 29.6% of recipients with DGF de- veloped acute rejection (biopsy-proven rejection and clinically suspected rejection) compared with 29.2% of recipients without DGF (p=ns). The rate of all surgical complications was 33.3% and 25% in recipients with and without DGF (p=ns). However, DGF prolonged significantly the length of hospitaliza- tion in DGF than non-DGF group (18.9 vs 13 days, p=0.000). Donor BMI 􏰤 30 kg/m2􏰁􏰀􏰚􏰌􏰈􏰏􏰥􏰏􏰌􏰝􏰣􏰀􏰕􏰉􏰂􏰀􏰤 30 kg/m2 and pre-transplant dialysis duration increased the risk of DGF in a multivariate logistic regression analysis. Conclusions: Apart from longer hospital stay, DGF had no deleterious impact on the future of DCD kidney allografts. Comparable graft and patient survival, renal function, rejection rate and surgical com- plications were observed between groups with and without DGF. [less ▲]

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See detailResults of kidney transplantation from controlled donors after cardio-circulatory death: a single center experience.
Ledinh, H.; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

in Transplant International (2012), 25

The aim of this study was to determine results of kidney transplantation (KT) from controlled donation after cardio-circulatory death (DCD). Primary end-points were graft and patient survival, and post ... [more ▼]

The aim of this study was to determine results of kidney transplantation (KT) from controlled donation after cardio-circulatory death (DCD). Primary end-points were graft and patient survival, and post-transplant complications. The influence of delayed graft function (DGF) on graft survival and DGF risk factors were analyzed as secondary end-points. This is a retrospective mono-center review of a consecutive series of 59 DCD-KT performed between 2005 and 2010. Overall graft survival was 96.6%, 94.6%, and 90.7% at 3 months, 1 and 3 years, respectively. Main cause of graft loss was patient's death with a functioning graft. No primary nonfunction grafts. Renal graft function was suboptimal at hospital discharge, but nearly normalized at 3 months. DGF was observed in 45.6% of all DCD-KT. DGF significantly increased postoperative length of hospitalization, but had no deleterious impact on graft function or survival. Donor body mass index >/=30 was the only donor factor that was found to significantly increase the risk of DGF (P < 0.05). Despite a higher rate of DGF, controlled DCD-KT offers a valuable contribution to the pool of deceased donor kidney grafts, with comparable mid-term results to those procured after brain death. [less ▲]

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See detailOutcome of the living kidney donor
DELANAYE, Pierre ULg; WEEKERS, Laurent ULg; DUBOIS, Bernard ULg et al

in Nephrology Dialysis Transplantation (2012), 27(1), 41-50

Renal transplantation from living kidney donors is still relatively marginal in most of the European countries. However, this source of kidney grafts may help to overcome in part the organ donor shortage ... [more ▼]

Renal transplantation from living kidney donors is still relatively marginal in most of the European countries. However, this source of kidney grafts may help to overcome in part the organ donor shortage of cadaveric donors. The living donor strategy implies correct and objective information about donation risks and completely free acceptance of the living candidate of the donation. In this paper, we reviewed the consequences of kidney donation on the living donor health, considering very short term (linked to the surgery), short term (effect of nephrectomy on glomerular filtration rate) and long term (risk of mortality, chronic kidney disease, proteinuria and hypertension) consequences of kidney donation. [less ▲]

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See detailA multicenter, randomized, double-blind study comparing different FK778 doses (manitimus) with tacrolimus and steroids vs. MMF with tacrolimus and steroids in renal transplantation
Wlodarczyk, Zbigniew; Vanrenterghem, Yves; Krämer, Bernhard k et al

in BMC Nephrology (2012), 13

Background: This multicenter phase II study in renal transplantation compared 3 concentration-controlled ranges of FK778 (manitimus) with mycophenolate mofetil (MMF) both given in combination with ... [more ▼]

Background: This multicenter phase II study in renal transplantation compared 3 concentration-controlled ranges of FK778 (manitimus) with mycophenolate mofetil (MMF) both given in combination with tacrolimus and corticosteroids. Methods: 364 patients were randomized to 12-month treatment: high-level FK778 group (H, N = 87) received 4x600mg/day (4 days) followed by 120 mg/day; mid-level FK778 group (M, N = 92) received 3x600mg/day (3 days) followed by 110 mg/day, low-level FK778 group (L, N = 92) received 2x600mg/day (2 days) followed by 100 mg/day, and control group received MMF 1 g/day (MMF, N = 93). After week 6, FK778 doses were adjusted to trough ranges of 75–125 μg/mL (H), 50–100 μg/mL (M) and 25–75 μg/mL (L). Tacrolimus and steroids were administered at the same dose in each of the 4 groups. Results: Biopsy proven acute rejection (BPAR) at 24 weeks, the primary study endpoint, was comparable in the L (22.8%) and MMF (17.2%) groups but higher in the H (34.5%) and M (29.3%) groups. BPAR at 12 months was comparable in the L (23.9%) and MMF (19.4%) groups but higher in the H (34.5%) and M (31.5%) groups. Graft and patient survival were lowest in the H group and renal function was poorest in the H and M groups. Premature study withdrawal was highest in the H group. Conclusions: Efficacy was similar between the low-level FK778 and MMF groups. Increased FK778 exposure was poorly tolerated and did not improve efficacy. [less ▲]

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