Interstitial Fibrosis Quantification in Renal Transplant Recipients Randomized to Continue Cyclosporine or Convert to Sirolimus

被引：61

作者：

Servais, A. ^{[1
,3
]}

Meas-Yedid, V. ^{[4
]}

Toupance, O. ^{[5
]}

Lebranchu, Y. ^{[6
]}

Thierry, A. ^{[7
]}

Moulin, B. ^{[8
]}

Etienne, I. ^{[9
]}

Presne, C. ^{[10
]}

Hurault, de Ligny B. ^{[11
]}

Le Pogamp, P. ^{[12
]}

Le Meur, Y. ^{[13
]}

Glotz, D. ^{[14
]}

Hayem, C. ^{[15
]}

Marin, J. C. Olivo ^{[4
]}

Thervet, E. ^{[2
,3
]}

机构：

[1] Hop Necker Enfants Malad, Dept Nephrol, AP HP, Paris, France

[2] Hop Necker Enfants Malad, Dept Renal Transplantat, AP HP, Paris, France

[3] Univ Paris 05, Paris, France

[4] Inst Pasteur, Unite Anal Images Quantitat, Paris, France

[5] CHU Reims, Dept Nephrol, Reims, France

[6] CHU Tours, Dept Nephrol, Tours, France

[7] CHU Poitiers, Dept Nephrol, Poitiers, France

[8] CHU Strasbourg, Dept Nephrol, Strasbourg, France

[9] CHU Rouen, Dept Nephrol, Rouen, France

[10] CHU Amiens, Dept Nephrol, Amiens, France

[11] CHU Caen, Dept Nephrol, Caen, France

[12] CHU Rennes, Dept Nephrol, Rennes, France

[13] CHU Brest, Dept Nephrol, Brest, France

[14] CHU St Louis, Dept Nephrol, St Louis, France

[15] Lab Roche, Roche, France

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2009年 / 9卷 / 11期

关键词：

Calcineurin inhibitor toxicity; chronic allograft nephropathy (CAN); glomerular filtration rate; interstitial fibrosis; sirolimus; CHRONIC ALLOGRAFT NEPHROPATHY; ACUTE REJECTION EPISODES; TERM GRAFT FUNCTION; PROTOCOL BIOPSIES; IMAGE-ANALYSIS; KIDNEY-TRANSPLANTATION; MYCOPHENOLATE-MOFETIL; RISK-FACTORS; WITHDRAWAL; THERAPY;

D O I：

10.1111/j.1600-6143.2009.02803.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Conversion from cyclosporine (CsA) to sirolimus at week 12 after kidney transplantation is associated with a significant improvement in renal function. The aim of this analysis was to investigate the effect of this conversion on interstitial fibrosis (IF), a hallmark of chronic allograft injury, in patients taking part in the CONCEPT trial. This multicenter, prospective, trial included 193 renal recipients randomized at week 12 to switch from CsA to sirolimus or to continue CsA, with mycophenolate mofetil. Routine biopsy with automated, quantified assessment of IF by a program of color segmentation was performed at 1 year in 121 patients. At 1 year, renal function was significantly improved in the conversion group as assessed by estimated GFR (MDRD) and measured GFR. Biopsy results, however, showed no between-group difference in percentage of IF. Calculated GFR at 1 year was significantly associated with the percentage of IF (p = 0.004, R2 = 0.07). By multivariate analysis diabetic patients had more fibrosis than non-diabetic patients. In conclusion, although kidney transplant patients converted from CsA to sirolimus showed significant improvement in renal function, we found no difference of IF on 1-year biopsies.

引用

页码：2552 / 2560

页数：9