Maintenance immunosuppression regimens: Conversion, minimization, withdrawal, and avoidance

被引:23
作者
Yang, H [1 ]
机构
[1] PinnacleHlth Syst, Transplantat Serv, Harrisburg, PA 17105 USA
关键词
cyclosporine (CsA); tacrolimus (TAC); mycophenolate mofetil (MMF); sirolimus (SRL); corticosteroid withdrawal; calcineurin inhibitor (CNI) minimization; conversion;
D O I
10.1053/j.ajkd.2005.12.045
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
A wide choice of drug combinations is available to clinicians for immunosuppression regimens for their kidney transplant patients. Although many protocols have minimized early graft loss, the optimal long-term regimen is unknown. Recent studies clearly showed that cardiovascular death is now the leading cause of graft loss. Strategies must be developed that address this risk while keeping immunologic events low. Transplant physicians have focused on exploring regimens that minimize or avoid the use of corticosterolds. Studies also have started to explore protocols that minimize calcineurin Inhibitor therapy.
引用
收藏
页码:S37 / S51
页数:15
相关论文
共 112 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]  
Ahsan N, 1999, TRANSPLANTATION, V68, P1865
[3]   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
[4]   Post-transplant diabetes mellitus:: the last 10 years with tacrolimus [J].
Bäckman, LA .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2004, 19 :13-16
[5]   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
[6]   Steroid-free immunosuppression after kidney transplantation with antithymocyte globulin induction and cyclosporine and mycophenolate mofetil maintenance therapy. [J].
Birkeland, SA .
TRANSPLANTATION, 1998, 66 (09) :1207-1210
[7]   Conversion from cyclosporine to tacrolimus prevents transplant function loss due to acute steroid-resistant or chronic rejection in renal allograft recipients [J].
Blume, C ;
Hollenbeck, M ;
Ivens, K ;
Heering, P ;
Hetzel, GR ;
Grabensee, B .
TRANSPLANTATION PROCEEDINGS, 2001, 33 (7-8) :3161-3163
[8]   African-American renal transplant recipients benefit from early corticosteroid withdrawal under modern immunosuppression [J].
Boardman, RE ;
Alloway, RR ;
Alexander, JW ;
Buell, JF ;
Cardi, M ;
First, MR ;
Hanaway, MJ ;
Munda, R ;
Rogers, CC ;
Roy-Chaudhury, P ;
Susskind, B ;
Trofe, J ;
Woodle, ES .
AMERICAN JOURNAL OF TRANSPLANTATION, 2005, 5 (02) :356-365
[9]   Effect of immunosuppressive agents on long-term survival of renal transplant recipients - Focus on the cardiovascular risk [J].
Boots, JMM ;
Christiaans, MHL ;
van Hooff, JP .
DRUGS, 2004, 64 (18) :2047-2073
[10]  
Boots JMM, 2002, J AM SOC NEPHROL, V13, P221, DOI 10.1681/ASN.V131221