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Steroid-free immunosuppression in kidney transplant recipients and prograf monotherapy: an interim analysis of a prospective multicenter trial

Backman, L. (author)
Aselius, H. (author)
Lindberger, K. (author)
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Svensson, L. (author)
Strombom, U. (author)
Olausson, E. (author)
Hadimeri, Henrik, 1962 (author)
Deurell, S. I. (author)
Norrby, Jonny, 1965 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
Gabel, M. (author)
Ebermark, A. (author)
Olausson, Michael, 1956 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences
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 (creator_code:org_t)
Elsevier BV, 2006
2006
English.
In: Transplantation proceedings. - : Elsevier BV. - 0041-1345. ; 38:8, s. 2654-6
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • This report described an interim analysis of a investigator-driven multicenter trial in renal transplant recipients: the Prospective Quality of life Renal Transplantation Switch Study; Tacrolimus-based immunosuppression ("PQRST study"). Patients included in the trial initially treated with cyclosporine-based immunosuppression after renal transplantation who experienced side effects, such as hypertension, hyperlipidemia, hypertrichosis, or other adverse reactions, were converted to a tacrolimus-based immunosuppressive regimen (n = 31). Steroids were subsequently discontinued between 3 and 6 months after the conversion. As of today 19/31 (50%) patients have been successfully weaned off steroids with the remaining patients in this process. In this interim analysis, with a follow-up ranging from 1 to 18 months both patient and graft survivals were 100%. No patient experienced an acute rejection episode; none of the grafts were lost. Blood pressure decreased in 22/31 (71%) of the patients. No patient developed de novo diabetes or other serious side effect related to the conversion. Three patients were withdrawn from the trial because of side effects: bleeding, depression, and proteinuria. However, none of these adverse events were felt to be directly related to the change of the immunosuppressive regimen to tacrolimus monotherapy. In conclusion, conversion from cyclosporine to tacrolimus-based therapy was safe and well tolerated; it may improve the cardiovascular risk profile after kidney transplantation.

Keyword

Adult
Aged
Creatinine/blood
Cyclosporine/therapeutic use
Female
Follow-Up Studies
Graft Survival
Humans
Immunosuppressive Agents/therapeutic use
Kidney Diseases/classification/surgery
Kidney Transplantation/immunology/*physiology
Male
Middle Aged
Tacrolimus/*therapeutic use
Transplantation
Homologous

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