Reference : Delayed introduction of reduced-dose tacrolimus, and renal function in liver transplanta...
Scientific journals : Article
Human health sciences : Gastroenterology & hepatology
Human health sciences : Surgery
http://hdl.handle.net/2268/5478
Delayed introduction of reduced-dose tacrolimus, and renal function in liver transplantation: the 'ReSpECT' study
English
Neuberger, J. M. [> >]
Mamelok, R. D. [> >]
Neuhaus, P. [> >]
Pirenne, J. [> >]
Samuel, D. [> >]
Isoniemi, H. [> >]
Rostaing, L. [> >]
Rimola, A. [> >]
Marshall, S. [> >]
Mayer, A. D. [> >]
Fabregat-Prous, J. [> >]
Durand, F. [> >]
Friman, S. [> >]
Bechstein, W. [> >]
Schmidt, J. [> >]
Schemmer, P. [> >]
Hauss, J. P. [> >]
Clavien, P. A. [> >]
Broelsch, C. E. [> >]
Bernados, A. [> >]
Detry, Olivier mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie abdominale- endocrinienne et de transplantation >]
Bouillot, O. [> >]
Soderdahl, G. [> >]
Brekke, I. B. [> >]
Bentdal, O. [> >]
Mueller, A. [> >]
Dreske, B. [> >]
Colle, I. [> >]
Cuervas-Mons, V. [> >]
Salcedo, M. [> >]
Zuelke, C. [> >]
Schlitt, H. [> >]
Suarez, M. F. [> >]
Patch, D. [> >]
Declerck, N. [> >]
Varo, E. [> >]
Boon, N. [> >]
Feb-2009
American Journal of Transplantation
Blackwell Publishing
9
2
327-336
Yes (verified by ORBi)
International
1600-6135
1600-6143
[en] liver Transplantation ; renal insufficiency
[en] We report a multicenter, prospective, randomized, open-label trial investigating the effect of lower levels and delayed introduction of tacrolimus on renal function in liver transplant recipients. Adult patients with good renal function undergoing primary liver transplant were randomized to either: group A (standard-dose tacrolimus [target trough levels >10 ng/mL] and corticosteroids; n = 183); group B (mycophenolate mofetil [MMF] 2g/day, reduced-dose tacrolimus [target trough levels </=8 ng/mL], and corticosteroids; n = 170); group C (daclizumab induction, MMF, reduced-dose tacrolimus delayed until the fifth day posttransplant and corticosteroids, n = 172). The primary endpoint was change from baseline in estimated glomerular filtration rate (eGFR) at 52 weeks. The eGFR decreased by 23.61, 21.22 and 13.63 mL/min in groups A, B and C, respectively (A vs C, p = 0.012; A vs B, p = 0.199). Renal dialysis was required less frequently in group C versus group A (4.2% vs. 9.9%; p = 0.037). Biopsy-proven acute rejection rates were 27.6%, 29.2% and 19.0%, respectively. Patient and graft survival was similar. In conclusion, daclizumab induction, MMF, corticosteroids and delayed reduced-dose tacrolimus was associated with less nephrotoxicity than therapy with standard-dose tacrolimus and corticosteroids without compromising efficacy or tolerability.
Professionals ; Students ; General public
http://hdl.handle.net/2268/5478

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