Comparing the Effect of Immediate versus Delayed Initiation of Tacrolimus on Delayed Graft Function in Kidney Transplant Recipients: A Randomized Open-label Clinical Trial.

التفاصيل البيبلوغرافية
العنوان:	Comparing the Effect of Immediate versus Delayed Initiation of Tacrolimus on Delayed Graft Function in Kidney Transplant Recipients: A Randomized Open-label Clinical Trial.
المؤلفون:	Ghadimi M; Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.; Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran., Dashti-Khavidaki S; Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Khatami MR; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Mahdavi-Mazdeh M; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Gatmiri M; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Minoo FS; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Naderi N; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Jafari A; Department of Clinical Pharmacy, Guilan University of Medical Sciences, Rasht, Iran., Abbasi MR; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Ghafari A; Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
المصدر:	Journal of research in pharmacy practice [J Res Pharm Pract] 2018 Apr-Jun; Vol. 7 (2), pp. 69-76.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Medknow Publications and Media Pvt. Ltd., part of Wolters Kluwer Health Country of Publication: India NLM ID: 101614023 Publication Model: Print Cited Medium: Print ISSN: 2319-9644 (Print) Linking ISSN: 2279042X NLM ISO Abbreviation: J Res Pharm Pract Subsets: PubMed not MEDLINE
أسماء مطبوعة:	Original Publication: Mumbai, India : Medknow Publications and Media Pvt. Ltd., part of Wolters Kluwer Health
مستخلص:	Objective: Delayed graft function (DGF) is an early complication after kidney transplantation with negative impact on allograft outcomes. This study assessed the effect of delayed initiation of tacrolimus as a nephrotoxic drug, on DGF occurrence and allograft function. Methods: This randomized, open-label clinical trial was conducted on kidney transplant recipients with the age of at least 14 years who underwent the first kidney transplantation from deceased or living donor. Patients were randomly allocated to immediate ( n = 26) or delayed tacrolimus ( n = 27) groups. All patients received thymoglobulin as induction therapy and similar maintenance immunosuppression including tacrolimus, mycophenolate, and prednisolone with the difference in the time of initiation of tacrolimus either on the day of transplantation (immediate tacrolimus group) or day 3 after transplant (delayed tacrolimus group). Findings: DGF incidence (46.15% vs. 37.04%; P = 0.501) and duration (9.75 ± 6.41 vs. 8.6 ± 6.16 days; P = 0.675) were not different between the immediate and delayed tacrolimus groups. Estimated creatinine clearance using Cockcroft-Gault equation (63.14 ± 18.81 vs. 58.19 ± 19.42 mL/min in immediate and delayed tacrolimus groups respectively; P = 0.373) and estimated acute rejection-free survival were also comparable between the groups over the 3 months of follow-up. Compared with the immediate group, the delayed tacrolimus group showed higher estimated 3-month grafts' survival (100% vs. 84.27%; P = 0.072). Conclusion: Delayed initiation of tacrolimus after kidney transplantation under the umbrella of thymoglobulin induction did not result in either lower incidence or duration of DGF or improved the level of graft function in kidney transplant recipients but non-statistically significant increased 3-month grafts' survival. Competing Interests: There are no conflicts of interest.
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فهرسة مساهمة:	Keywords: Delayed graft function; delayed Tacrolimus; immediate Tacrolimus; kidney transplantation
تواريخ الأحداث:	Date Created: 20180728 Latest Revision: 20220318
رمز التحديث:	20240628
مُعرف محوري في PubMed:	PMC6036871
DOI:	10.4103/jrpp.JRPP_17_90
PMID:	30050959
قاعدة البيانات:	MEDLINE

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تدمد:	2319-9644
DOI:	10.4103/jrpp.JRPP_17_90