Title
Recovery of graft function in pediatric kidney transplantation is not affected by delayed introduction of cyclosporine Recovery of graft function in pediatric kidney transplantation is not affected by delayed introduction of cyclosporine
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Baltimore, Md ,
Subject
Human medicine
Source (journal)
Transplantation. - Baltimore, Md, 1963, currens
Volume/pages
86(2008) :9 , p. 1199-1205
ISSN
0041-1337
1534-6080
ISI
000260945600008
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Background. Delayed graft function and acute rejections adversely affect the long-term survival of kidney transplantation. To decrease the incidences of these phenomena, we changed the initial immunosuppressive protocol in pediatric kidney transplantation in the Netherlands. Methods. We compared a cohort (n=123) treated with basiliximab and delayed onset cyclosporine (CsA) with the preceding cohort (n=110) in which CsA was started already preoperatively. Both cohorts were treated with mycophenolate mofetil and corticosteroids as well. All consecutive transplantations were included. Results. The incidence of delayed graft function did not significantly differ between the cohorts (10% and 13%, in basiliximab and control group). Significantly fewer patients in the basiliximab group had acute rejection episodes (20% vs. 36% in control group, P=0.007). The mean estimated glomerular filtration rate at 1 year and graft survival at 2 years posttransplant did not differ between groups (62 vs. 64 mL/min 1.73 m2, and 89% vs. 92%, respectively). Conclusion. Postponed onset of CsA in triple immunosuppressive therapy (corticosteroids, CsA, and mycophenolate mofetil) with addition of basiliximab did not reduce the incidence of delayed graft function in pediatric kidney transplantation. Yet, fewer acute rejections were noted. Long-term favorable effects could not be detected in this study.
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