دورية أكاديمية
The Effect of Donor Age and Recipient Characteristics on Renal Outcomes in Patients Receiving Prolonged-Release Tacrolimus After Liver Transplantation: Post-Hoc Analyses of the DIAMOND Study.
| العنوان: | The Effect of Donor Age and Recipient Characteristics on Renal Outcomes in Patients Receiving Prolonged-Release Tacrolimus After Liver Transplantation: Post-Hoc Analyses of the DIAMOND Study. |
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| المؤلفون: | Trunečka P; Transplantcenter, Institute for Clinical and Experimental Medicine, Prague, Czech Republic., Klempnauer J; Department of General-, Visceral- and Transplantation Surgery, Hannover Medical School, Hannover, Germany., Bechstein WO; Department of Surgery, Goethe University Hospital and Clinics, Frankfurt, Germany., Pirenne J; Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium., Bennet W; The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden., Zhao A; Department of Abdominal Surgery, A.V. Vishnevsky Institute of Surgery, Moscow, Russian Federation., Isoniemi H; Department of Transplantation and Liver Surgery Clinic, Helsinki University Hospital, Helsinki, Finland., Rostaing L; Department of Nephrology and Organ Transplantation, Toulouse University Hospital, Toulouse, France., Settmacher U; Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany., Mönch C; Department of Surgery, Goethe University Hospital and Clinics, Frankfurt, Germany.; Department of General, Visceral and Transplantation Surgery, Westpfalz-Klinikum Hospital, Kaiserslautern, Germany., Brown M; Astellas Pharma, Medical Affairs - Global, Northbrook, IL, USA., Undre N; Astellas Pharma Europe Ltd., Chertsey, United Kingdom., Kazeem G; Astellas Pharma Europe Ltd., Chertsey, United Kingdom.; BENKAZ Consulting Ltd., Cambridge, United Kingdom., Tisone G; Transplant and Hepatobiliary Unit, Department of Surgery, University of Rome Tor Vergata, Rome, Italy. |
| المصدر: | Annals of transplantation [Ann Transplant] 2019 Jun 04; Vol. 24, pp. 319-327. Date of Electronic Publication: 2019 Jun 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: International Scientific Literature, Inc Country of Publication: United States NLM ID: 9802544 Publication Model: Electronic Cited Medium: Internet ISSN: 2329-0358 (Electronic) Linking ISSN: 14259524 NLM ISO Abbreviation: Ann Transplant Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2013- > : Smithtown, New York: International Scientific Literature, Inc. Original Publication: Warsaw : Polish Transplantology Foundation : Transplantation Institute, Warsaw Medical School, 1996- |
| مواضيع طبية MeSH: | Tissue Donors* , Transplant Recipients*, Immunosuppressive Agents/*therapeutic use , Kidney/*drug effects , Kidney Failure, Chronic/*surgery , Liver Transplantation/*methods , Tacrolimus/*therapeutic use, Adult ; Age Factors ; Aged ; Delayed-Action Preparations ; Female ; Graft Rejection/drug therapy ; Graft Rejection/prevention & control ; Humans ; Immunosuppressive Agents/administration & dosage ; Kidney Function Tests ; Male ; Middle Aged ; Mycophenolic Acid/administration & dosage ; Mycophenolic Acid/therapeutic use ; Tacrolimus/administration & dosage |
| مستخلص: | BACKGROUND The DIAMOND study of de novo liver transplant patients showed that prolonged-release tacrolimus exposure in the acute post-transplant period maintained renal function over 24 weeks of treatment. To assess these findings further, we performed a post-hoc analysis in patients according to baseline kidney function, Model for End-stage Liver Disease [MELD] scores, and donor age. MATERIAL AND METHODS Patients received prolonged-release tacrolimus (initial-dose, Arm 1: 0.2 mg/kg/day, Arm 2: 0.15-0.175 mg/kg/day, Arm 3: 0.2 mg/kg/day delayed until Day 5), mycophenolate mofetil and 1 steroid bolus. Arms 2 and 3 also received basiliximab. The recommended tacrolimus target trough levels to Day 42 post-transplantation were 5-15 ng/mL in all arms. In this post-hoc analysis, change in renal outcome, based on estimated glomerular filtration rate (eGFR), Modified Diet in Renal Disease-4 (MDRD4), values from baseline to Week 24 -post-transplantation, were assessed according to baseline patient factors: eGFR (≥60 and ˂60 mL/min/1.73 m²), MELD score (˂25 and ≥25) and donor age (˂50 and ≥50 years). RESULTS Baseline characteristics were comparable (Arms 1-3: n=283, n=287, n=274, respectively). Patients with baseline renal function, eGFR ≥60 mL/min/1.73 m², experienced a decrease in eGFR in all tacrolimus treatment arms. In patients with lower baseline renal function (eGFR ˂60 mL/min/1.73 m²), an advantage for renal function was observed with both the early lower-dose and delayed higher-dose tacrolimus regimens compared with the early introduction of higher-dose tacrolimus. At Week 24, renal function was higher in the early-lower tacrolimus arm with older donors, and the delayed higher-dose tacrolimus arm with younger donors, both compared with early higher-dose tacrolimus. CONCLUSIONS Pre-transplantation factors, such as renal function and donor age, could guide the choice of prolonged-release tacrolimus regimen following liver transplantation. |
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| المشرفين على المادة: | 0 (Delayed-Action Preparations) 0 (Immunosuppressive Agents) HU9DX48N0T (Mycophenolic Acid) WM0HAQ4WNM (Tacrolimus) |
| تواريخ الأحداث: | Date Created: 20190605 Date Completed: 20200116 Latest Revision: 20200225 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC6568030 |
| DOI: | 10.12659/AOT.913103 |
| PMID: | 31160549 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2329-0358 |
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| DOI: | 10.12659/AOT.913103 |