Planned randomized conversion from tacrolimus to sirolimus-based immunosuppressive regimen in de novo kidney transplant recipients

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dc.contributor.authorSilva H.T.
dc.contributor.authorFelipe C.R.
dc.contributor.authorGarcia V.D.
dc.contributor.authorNeto E.D.
dc.contributor.authorFilho M.A.
dc.contributor.authorContieri F.L.C.
dc.contributor.authorDe Carvalho D.D.B.M.
dc.contributor.authorPestana J.O.M.
dc.date.accessioned2024-03-13T01:06:02Z
dc.date.available2024-03-13T01:06:02Z
dc.date.issued2013
dc.description.abstractPlanned conversion from tacrolimus to sirolimus was evaluated in de novo kidney transplant recipients. In this multicenter, randomized, open-label study, 297 patients were initially treated with tacrolimus, mycophenolate sodium and prednisone. Of the 283 patients reaching 3 months, 97 were converted to sirolimus (SRL), 107 were maintained on tacrolimus (TAC) and 79 were patients receiving TAC without criteria to undergo intervention at month 3 (TACex). The primary objective was to show superior estimated glomerular filtration rate (eGFR) in the SRL group at month 24. Of the 258 patients who completed 24 months, 91 (94%) were in the SRL group, 101 (94%) in the TAC group and 66 (84%) in the TACex group. In the intention-to-treat population there were no differences in eGFR (66.2 ± 25.3 vs. 70.7 ± 25.1, p = 0.817) or in the severity of chronic sclerosing lesions scores in 24-month protocol biopsies. Higher mean urinary protein-to-creatinine ratio (0.36 ± 0.69 vs. 0.15 ± 0.53, p = 0.03) and higher incidence of treated acute rejection between months 3-24 (13.4% vs. 4.7%, p = 0.047) were observed in SRL compared to TAC group. In this population planned conversion from TAC to SRL 3 months after kidney transplantation was not associated with improved renal function at 24 months. In this multicenter, randomized, open-label study, the authors show that planned conversion from tacrolimus to sirolimus 3 months after kidney transplantation was not associated with improved renal function or histological structure at 24 months. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.
dc.description.firstpage3155
dc.description.issuenumber12
dc.description.lastpage3163
dc.description.volume13
dc.identifier.doi10.1111/ajt.12481
dc.identifier.issn1600-6143
dc.identifier.urihttps://dspace.mackenzie.br/handle/10899/36692
dc.relation.ispartofAmerican Journal of Transplantation
dc.rightsAcesso Aberto
dc.subject.otherlanguageConversion
dc.subject.otherlanguageKidney transplantation
dc.subject.otherlanguageSirolimus
dc.subject.otherlanguageTacrolimus
dc.titlePlanned randomized conversion from tacrolimus to sirolimus-based immunosuppressive regimen in de novo kidney transplant recipients
dc.typeArtigo
local.scopus.citations40
local.scopus.eid2-s2.0-84888371502
local.scopus.updated2024-05-01
local.scopus.urlhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84888371502&origin=inward
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