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The role of immunosuppression in long-term graft hepatitis and fibrosis after paediatric liver transplant - comparison of two treatment protocols.
Front Transplant
February 2023
Liver Unit, Birmingham Woman's and Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom.
Background And Aims: We have previously demonstrated high rates of chronic allograft hepatitis and fibrosis in liver transplant patients on long-term cyclosporine monotherapy. We subsequently changed practice to add low-dose prednisolone to maintenance treatment with tacrolimus post-transplant. The aim of the study was to assess the impact of the immunosuppression change on graft histopathology.
View Article and Find Full Text PDFDifferential risks for adverse outcomes 3 years after kidney transplantation based on initial immunosuppression regimen: a national study.
Transpl Int
November 2016
Saint Louis University School of Medicine, Saint Louis, MO, USA.
We examined integrated national transplant registry, pharmacy fill, and medical claims data for Medicare-insured kidney transplant recipients in 2000-2011 (n = 45 164) from the United States Renal Data System to assess the efficacy and safety endpoints associated with seven early (first 90 days) immunosuppression (ISx) regimens. Risks of clinical complications over 3 years according to IS regimens were assessed with multivariate regression analysis, including the adjustment for covariates and propensity for receipt of a nonreference ISx regimen. Compared with the reference ISx (thymoglobulin induction with tacrolimus, mycophenolate, and prednisone maintenance), sirolimus-based ISx was associated with significantly higher three-year risks of pneumonia (adjusted hazard ratio, aHR 1.
View Article and Find Full Text PDFVariation in Comedication Use According to Kidney Transplant Immunosuppressive Regimens: Application of Integrated Registry and Pharmacy Claims Data.
Transplant Proc
October 2016
Washington University, St Louis, Missouri.
Background: Modern immunosuppression therapies (ISx) have many side effects, and transplant recipients must take an array of "comedications" to help mitigate complications. Comedication use patterns are not well described in large, representative samples because of lack of data.
Methods: We integrated national U.
The impact of tacrolimus as rescue therapy in children using a double immunosuppressive regimen after heart transplantation.
Transplant Proc
October 2012
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Background: Organ transplant recipients with refractory rejection or intolerance to the prescribed immunosuppressant may respond to rescue therapy with tacrolimus. We sought to evaluate the clinical outcomes of children undergoing heart transplantation who required conversion from a cyclosporine-based, steroid-free therapy to a tacrolimus-based regimen.
Methods: We performed a prospective, observational, cohort study of 28 children who underwent conversion from cyclosporine-based, steroid-free therapy to a tacrolimus-based therapy for refractory or late rejection or intolerance to cyclosporine.
Glucose metabolism before and after conversion from cyclosporine microemulsion to tacrolimus in stable renal recipients.
Nephrol Dial Transplant
February 2008
Department of Internal Medicine, Subdivision Nephrology, University Hospital Maastricht, 6202 AZ Maastricht, The Netherlands.
Background: Tacrolimus is more diabetogenic than cyclosporine. However, this difference is only discernible in the first few months after renal transplantation. In randomized trials, investigating the effects of immunosuppression after renal transplantation, no increase in diabetes mellitus has been reported.
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