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1.
Int Urol Nephrol ; 39(1): 317-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17333530

RESUMO

BACKGROUND/AIMS: The aim of this work is to determine the long-term therapeutic benefit(s) of daclizumab induction therapy with triple immunosuppressive protocols including prednisolone, cyclosporine microemulsion (CsA), and mycophenolate mofetil (MMF) in the living related donor kidney transplantation. METHODS: Twenty-one adult recipients of their first kidney allograft were allocated to receive daclizumab with triple immunosuppressive therapy (steroids, CsA, and MMF). They were compared to 50 recipients of their first grafts who received a maintenance triple immunosuppressive therapy (steroids, CsA, and azathioprine). The patients were followed up for 5 years. RESULTS: Daclizumab group significantly experienced a marked reduction of acute rejection (7/21) when compared to the control group (31/50) with subsequent significant reduction of cumulative steroids doses at the end of 5 years. The overall incidence of post-transplant complications was comparable among the two treatment groups. There was no significant difference in patients and graft survival; 5-year patient and graft survival were 95.3%, 85.7% for daclizumab and 96%, 88% for control group, respectively. CONCLUSIONS: Although prophylactic daclizumab with triple immunosuppressive protocol including MMF have drastically reduced the incidence of acute rejections, the graft and patient survival are unchanged in this long-term follow up.


Assuntos
Anticorpos Monoclonais/farmacologia , Imunoglobulina G/farmacologia , Imunossupressores/farmacologia , Transplante de Rim , Doadores Vivos , Ácido Micofenólico/análogos & derivados , Doadores de Tecidos , Análise Atuarial , Adulto , Anticorpos Monoclonais Humanizados , Daclizumabe , Demografia , Quimioterapia Combinada , Feminino , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto/efeitos dos fármacos , Humanos , Masculino , Ácido Micofenólico/farmacologia , Análise de Sobrevida , Fatores de Tempo
2.
Am J Nephrol ; 25(3): 221-5, 2005 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15908741

RESUMO

BACKGROUND/AIMS: The long-term evaluation of basiliximab induction therapy has not been addressed yet. We aim to evaluate its long-term effects in living related donor kidney transplantation. METHODS: 100 adult recipients with their first kidney allograft were randomized into two treatment groups--one group received basiliximab and the second served as a control. All patients received a maintenance triple immunosuppressive therapy (steroids, cyclosporine microemulsion and azathioprine) and were closely followed for 5 years. RESULTS: Basiliximab significantly reduced the proportion of patients who experienced an acute rejection in the first year (18/50) when compared to the control group (31/50) and in 5 years (27/50) when compared to (36/50) the controls. The cumulative steroid dose used throughout the study was significantly lower in the basiliximab group. The overall incidence of post-transplant complications was comparable between the two treatment groups. There was no significant difference in patients and graft survival; 5-year patient and graft survival were 100 and 86% for basiliximab, and 96 and 88% for the control group respectively. CONCLUSION: Although routine basiliximab induction significantly reduces the incidence of acute rejection, its beneficial long-term effects on graft function and patient and graft survival are not yet evident.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Imunossupressores/uso terapêutico , Transplante de Rim , Doadores Vivos , Proteínas Recombinantes de Fusão/uso terapêutico , Doença Aguda , Adulto , Basiliximab , Relação Dose-Resposta a Droga , Feminino , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto , Humanos , Incidência , Transplante de Rim/efeitos adversos , Estudos Longitudinais , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Esteroides/administração & dosagem , Esteroides/uso terapêutico
3.
J Nephrol ; 16(3): 393-8, 2003 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12832740

RESUMO

BACKGROUND: The aim of this work was to investigate the benefit of basiliximab induction therapy in living-related-donor kidney transplantation. METHODS: One hundred adult recipients of a first kidney allograft were randomized into two treatment groups, one to receive basiliximab and the second as a control. All patients received maintenance triple immunosuppressive therapy (steroids, cyclosporine microemulsion and azathioprine). The patients were followed up for a minimum of three years. The end points for evaluation included the incidence of acute rejection episodes, severity of rejection, cumulative steroid dose, patients' and graft survival. RESULTS: Basiliximab significantly reduced the proportion of patients who experienced an acute rejection in the first year (18/50) compared to the control group (31/50). At three years there were 26 acute rejections in the basiliximab group and 36 in control group. The cumulative steroid dose at three and 12 months was significantly lower in the basiliximab group. The overall incidence of post-transplant complications was comparable in the two groups. CONCLUSIONS: Prophylactic basiliximab is well tolerated and significantly reduces the incidence of acute rejection episodes in living-related-donor kidney transplantation.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Rejeição de Enxerto/prevenção & controle , Imunossupressores/uso terapêutico , Transplante de Rim , Doadores Vivos , Proteínas Recombinantes de Fusão , Doença Aguda , Adulto , Basiliximab , Relação Dose-Resposta a Droga , Feminino , Rejeição de Enxerto/epidemiologia , Humanos , Incidência , Estudos Longitudinais , Masculino , Esteroides/administração & dosagem
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