Minimization of calcineurin inhibitors to improve long-term outcomes in kidney transplantation

被引：20

作者：

Golshayan, Dela ^{[1
]}

Pascual, Manuel

机构：

[1] Univ Lausanne, CHUV, Transplantat Ctr, Div Nephrol, CH-1011 Lausanne, Switzerland

来源：

TRANSPLANT IMMUNOLOGY | 2008年 / 20卷 / 1-2期

基金：

瑞士国家科学基金会;

关键词：

Calcineurin inhibitors; Kidney transplantation; Immunosuppression; Chronic allograft nephropathy;

D O I：

10.1016/j.trim.2008.08.006

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Long-term outcomes after kidney transplantation remain suboptimal, despite the great achievements observed in recent years with the use of modern immunosuppressive drugs. Currently, the calcineurin inhibitors (CNI) cyclosporine and tacrolimus remain the cornerstones of immunosuppressive regimens in many centers worldwide, regardless of their well described side-effects, including nephrotoxicity. In this article, we review recent CNI-minimization strategies in kidney transplantation, while emphasizing on the importance of long-term follow-up and patient monitoring. Finally, accumulating data indicate that low-dose CNI-based regimens would provide an interesting balance between efficacy and toxicity. (C) 2008 Elsevier B.V. All rights reserved.

引用

页码：21 / 28

页数：8

共 87 条

[1] Cyclosporine withdrawal from a mycophenolate mofetil-containing immunosuppressive regimen in stable kidney transplant recipients: A randomized, controlled study [J].

Abramowicz, D ;

Manas, D ;

Lao, M ;

Vanrenterghem, Y ;

del Castillo, D ;

Wijngaard, P ;

Fung, S .

TRANSPLANTATION, 2002, 74 (12) :1725-1734

[2] Cyclosporine withdrawal from a mycophenolate mofetil-containing immunosuppressive regimen: Results of a five-year, prospective, randomized study [J].

Abramowicz, D ;

Rial, MD ;

Vitko, S ;

del Castillo, D ;

Manas, D ;

Lao, M ;

Gafner, N ;

Wijngaard, P .

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2005, 16 (07) :2234-2240

[3] Low-dose mycophenolate mofetil is an effective and safe treatment to permit phased reduction in calcineurin inhibitors in chronic allograft nephropathy [J].

Aftali, B ;

Shah, S ;

Chowdhury, P ;

O'Sullivan, H ;

Taylor, J ;

Goldsmith, D .

TRANSPLANTATION, 2005, 79 (03) :304-309

[4] Randomized trial of tacrolimus plus mycophenolate mofetil or azathioprine versus cyclosporine oral solution (modified) plus mycophenolate mofetil after cadaveric kidney transplantation: Results at 2 years [J].

Ahsan, N ;

Johnson, C ;

Gonwa, T ;

Halloran, P ;

Stegall, M ;

Hardy, M ;

Metzger, R ;

Shield, C ;

Rocher, L ;

Scandling, J ;

Sorensen, J ;

Mulloy, L ;

Light, J ;

Corwin, C ;

Danovitch, G ;

Wachs, M ;

VanVeldhuisen, P ;

Salm, K ;

Tolzman, D ;

Fitzsimmons, WE .

TRANSPLANTATION, 2001, 72 (02) :245-250

[5] Conversion from cyclosporine to tacrolimus improves quality-of-life indices, renal graft function and cardiovascular risk profile [J].

Artz, MA ;

Boots, JMM ;

Ligtenberg, G ;

Roodnat, JI ;

Christiaans, MHL ;

Vos, PF ;

Moons, P ;

Borm, G ;

Hilbrands, LB .

AMERICAN JOURNAL OF TRANSPLANTATION, 2004, 4 (06) :937-945

[6] Use of sirolimus in solid organ transplantation [J].

Augustine, Joshua J. ;

Bodziak, Kenneth A. ;

Hricik, Donald E. .

DRUGS, 2007, 67 (03) :369-391

[7] Cardiovascular risk profile after conversion from cyclosporine A to tacrolimus in stable renal transplant recipients [J].

Baid-Agrawal, S ;

Delmonico, FL ;

Tolkoff-Rubin, NE ;

Farrell, M ;

Williams, WW ;

Shih, V ;

Auchincloss, H ;

Cosimi, AB ;

Pascual, M .

TRANSPLANTATION, 2004, 77 (08) :1199-1202

[8] Loss of direct and maintenance of indirect alloresponses in renal allograft recipients: Implications for the pathogenesis of chronic allograft nephropathy [J].

Baker, RJ ;

Hernandez-Fuentes, MP ;

Brookes, PA ;

Chaudhry, AN ;

Cook, HT ;

Lechler, RI .

JOURNAL OF IMMUNOLOGY, 2001, 167 (12) :7199-7206

[9] Outcomes at 3 years of a prospective pilot study of Campath-1H and sirolimus immunosuppression for renal transplantation [J].

Barth, Rolf N. ;

Janus, Christina A. ;

Lillesand, Christine A. ;

Radke, Nancy A. ;

Pirsch, John D. ;

Becker, Bryan N. ;

Fernandez, Luis A. ;

Chin, L. Thomas ;

Becker, Yolanda T. ;

Odorico, Jon S. ;

D'Alessandro, Anthony M. ;

Sollinger, Hans W. ;

Knechtle, Stuart J. .

TRANSPLANT INTERNATIONAL, 2006, 19 (11) :885-892

[10] LONG-TERM EFFICACY AND SAFETY OF CYCLOSPORINE IN RENAL-TRANSPLANT RECIPIENTS [J].

BURKE, JF ;

PIRSCH, JD ;

RAMOS, EL ;

SALOMON, DR ;

STABLEIN, DM ;

VANBUREN, DH ;

WEST, JC .

NEW ENGLAND JOURNAL OF MEDICINE, 1994, 331 (06) :358-363

← 1 2 3 4 5 6 7 8 9 →