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Long-term outcomes of thoracic transplant recipients following conversion to everolimus with reduced calcineurin inhibitor in a multicenter, open-label, randomized trial
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- Gullestad, Lars (author)
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, K.G. Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
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- Eiskjaer, Hans (author)
- Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
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- Gustafsson, Finn (author)
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark,Copenhagen University Hospital
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- Riise, Gerdt C (author)
- Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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- Karason, Kristjan (author)
- Department of Cardiology and Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
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- Dellgren, Göran (author)
- Department of Cardiology and Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
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- Rådegran, Göran (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Hansson, Lennart (author)
- Lund University,Lunds universitet,Lungmedicin, allergologi och palliativ medicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Respiratory Medicine, Allergology, and Palliative Medicine,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Gude, Einar (author)
- Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, K.G. Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway
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- Bjørtuft, Øystein (author)
- Department of Respiratory Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
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- Jansson, Kjell (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US,Linköping University Hospital
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- Schultz, Hans Henrik (author)
- Division of Lung Transplantation, Department of Cardiology, Rigshospitalet, Copenhagen, Denmark,Copenhagen University Hospital
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- Solbu, Dag (author)
- Novartis Norge AS, Oslo, Norway
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- Iversen, Martin (author)
- Division of Lung Transplantation, Department of Cardiology, Rigshospitalet, Copenhagen, Denmark,Copenhagen University Hospital
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Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Faculty of Medicine, KG. Jebsen Cardiac Research Centre and Center for Heart Failure Research, University of Oslo, Oslo, Norway Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark (creator_code:org_t)
- 2016-05-30
- 2016
- English.
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In: Transplant International. - : Wiley-Blackwell Publishing Inc.. - 0934-0874 .- 1432-2277. ; 29:7, s. 819-829
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Abstract
Subject headings
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- The NOCTET study randomized 282 patients ≥1 year after heart or lung transplantation to continue conventional calcineurin inhibitor (CNI) therapy or to start everolimus with reduced-exposure CNI. Last follow-up, at ≥5 years postrandomization (mean: 5.6 years) was attended by 72/140 everolimus patients (51.4%) and 91/142 controls (64.1%). Mean measured GFR remained stable in the everolimus group from randomization (51.3 ml/min) to last visit (51.4 ml/min) but decreased in controls (from 50.5 ml/min to 45.3 ml/min) and was significantly higher with everolimus at last follow-up (P = 0.004). The least squares mean (SE) change from randomization was -1.5 (1.7)ml/min with everolimus versus -7.2 (1.7)ml/min for controls (difference: 5.7 [95% CI 1.7; 9.6]ml/min; P = 0.006). The difference was accounted for by heart transplant patients (difference: 6.9 [95% 2.3; 11.5]ml/min; P = 0.004). Lung transplant patients showed no between-group difference at last follow-up. Rates of rejection, death, and major cardiac events were similar between groups, as was graft function. Pneumonia was more frequent with everolimus (18.3% vs. 6.4%). In conclusion, introducing everolimus in maintenance heart transplant patients, with reduced CNI, achieves a significant improvement in renal function which is maintained for at least 5 years, but an early renal benefit in lung transplant patients was lost. Long-term immunosuppressive efficacy was maintained.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- calcineurin inhibitor
- certican
- cyclosporine
- everolimus
- heart
- lung
- randomized
- renal impairment
- tacrolimus
- transplantation
- Calcineurin inhibitor
- Certican
- Cyclosporine
- Everolimus
- Heart
- Lung
- Randomized
- Renal impairment
- Tacrolimus
- Transplantation
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Gullestad, Lars
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Eiskjaer, Hans
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Gustafsson, Finn
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Riise, Gerdt C
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Karason, Kristja ...
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Dellgren, Göran
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Rådegran, Göran
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Hansson, Lennart
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Gude, Einar
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Bjørtuft, Øystei ...
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Jansson, Kjell
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Schultz, Hans He ...
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Solbu, Dag
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Iversen, Martin
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Transplant Inter ...
- By the university
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Linköping University
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Lund University