Volume 7 Issue 2
Mar.  2016
Turn off MathJax
Article Contents
Article Navigation >  ORGAN TRANSPLANTATION  > 2016  >  7(2): 124-127
Pan Guozheng, Dai Shuai, Qiu Cheng, et al. Clinical efficacy and safety of reduced-dose tacrolimus combined with increased-dose mycophenolate mofetil after renal transplantation[J]. ORGAN TRANSPLANTATION, 2016, 7(2): 124-127. doi: 10.3969/j.issn.1674-7445.2016.02.009
Citation: Pan Guozheng, Dai Shuai, Qiu Cheng, et al. Clinical efficacy and safety of reduced-dose tacrolimus combined with increased-dose mycophenolate mofetil after renal transplantation[J]. ORGAN TRANSPLANTATION, 2016, 7(2): 124-127. doi: 10.3969/j.issn.1674-7445.2016.02.009
shu

Clinical efficacy and safety of reduced-dose tacrolimus combined with increased-dose mycophenolate mofetil after renal transplantation

doi: 10.3969/j.issn.1674-7445.2016.02.009

  • Organ Transplantation Center, Anhui Provincial Hospital, Hefei 230001, China

More Information
  • Corresponding author: Liu Hongtao, Email:feng123456@126.com
  • Received Date: 2015-12-29
    Available Online: 2021-01-19
  • Publish Date: 2016-03-15
    Abstract
  •   Objective  To evaluate the clinical efficacy and safety of reduced-dose tacrolimus(FK506) in combination with increased-dose mycophenolate mofetil (MMF) after renal transplantation.  Methods  In this prospective study, 52 patients undergoing renal transplantation for over 12 months in the Department of Organ Transplantation, Anhui Provincial Hospital from January 2011 to January 2013 were recruited. All participants were randomly divided into the intervention group and control group(n=26 in each group). In the intervention group, blood trough concentration of FK506 was adjusted to 2.0-4.5 ng/ml and oral dose of MMF was adjusted to 1.5 g/d during 15 d after study. And in control group, blood trough concentration of FK506 was kept in 5.5-10.0 ng/ml and oral dose of MMF was 1.0 g/d constantly. The changes of the glomerular filtration rate (GFR) and serum creatinine (Scr) at 0 d, 15 d, and 2-, 4-, 6-, 8-, 10-, 12-month after corresponding treatment were statistically compared between two groups. At 1 year after therapy, triglyceride, total cholesterol and 24 h urinary protein levels were measured and compared between two groups. Moreover, the incidence of adverse reactions was also statistically compared.  Results  During the period from 0 d to 12 months after treatment, GFR did not significantly change in the control group (P > 0.05), whereas the value in the intervention group was considerably elevated (P < 0.05). The changes in terms of the GFR at 8-, 10-and 12-month after treatment significantly differed between two groups (all in P < 0.05). From 0 d to 12 months after therapy, the levels of Scr were significantly decreased in two groups (both in P < 0.05), and more apparent decline was noted in the intervention group. The changes in the Scr levels at 10 and 12 months after corresponding treatment significantly differed between two groups (both in P < 0.05). At 12 months after therapy, there was no significant difference in the levels of total cholesterol, triglyceride and mean 24 h urinary protein between the control and intervention groups (all in P > 0.05). No acute rejection or renal allograft dysfunction occurred in two groups. And there was no significant difference in the incidence of adverse reactions between the intervention and control groups (P > 0.05).  Conclusions  Combined therapy of reduced-dose FK506 and increased-dose MMF is an efficacious and safe immunosuppressive therapy.

     

    • FullText(HTML)
  • loading
    • References(17)
  • [1]
    Kaplan B, Qazi Y, Wellen JR. Strategies for the management of adverse events associated with mTOR inhibitors[J]. Transplant Rev, 2014, 28 (3): 126-133. doi: 10.1016/j.trre.2014.03.002
    [2]
    Tedesco Silva H Jr, Cibrik D, Johnston T, et al. Everolimus plus reduced-exposure CsA versus mycophenolic acid plus standard-exposure CsA in renal-transplant recipients[J]. Am J Transplant, 2010, 10 (6): 1401-1413. doi: 10.1111/ajt.2010.10.issue-6
    [3]
    Shihab F, Christians U, Smith L, et al. Focus on mTOR inhibitors and tacrolimus in renal transplantation: pharmacokinetics, exposure-response relationships, and clinical outcomes[J]. Transpl Immunol, 2014, 31 (1): 22-32. doi: 10.1016/j.trim.2014.05.002
    [4]
    Haywood S, Abecassis M, Levitsky J. The renal benefit of mycophenolate mofetil after liver transplantation[J]. Clin Transplant, 2011, 25(1): E88-E95. doi: 10.1111/ctr.2011.25.issue-1
    [5]
    Witzke O, Sommerer C, Arns W. Everolimus immunosuppression in kidney transplantation: what is the optimal strategy[J]. Transplant Rev, 2016, 30(1):3-12. doi: 10.1016/j.trre.2015.09.001
    [6]
    周林, 索龙龙, 宋继勇, 等.以西罗莫司为基础三联抗肿瘤疗法对大鼠肝癌肝移植复发模型T淋巴细胞的影响[J].器官移植, 2014, 5(6):368-373. http://www.organtranspl.com/browse/detail/qkid/33/id/179.html

    Zhou L, Suo LL, Song JY, et al. Influence of sirolimus based triple antitumor therapy on tlymphocyte of rat model with liver cancer recurrence after transplantation[J]. Organ Transplant, 2014, 5(6):368-373. http://www.organtranspl.com/browse/detail/qkid/33/id/179.html
    [7]
    Abdelmalek MF, Humar A, Stickel F, et al. Sirolimus conversion regimen versus continued calcineurin inhibitors in liver allograft recipients: a randomized trial[J]. Exp Clin Transplant, 2012, 12(3): 694-705. http://www.ncbi.nlm.nih.gov/pubmed/22233522
    [8]
    Diekmann F, Andrés A, Oppenheimer F. mTOR inhibitor-associated proteinuria in kidney transplant recipients[J]. Transplant Rev, 2012, 26 (1): 27-29. doi: 10.1016/j.trre.2011.10.003
    [9]
    Marschalek J, Györi GP, Silberhumer GR, et al. Simultaneous pancreas-kidney transplantation nine years after liver transplantation:a case report[J]. Transplant Proc, 2012, 44(10):3041-3043. doi: 10.1016/j.transproceed.2012.06.068
    [10]
    Wohlfahrtova M, Viklicky O. Recent trials in immunosuppression and their consequences for current therapy[J].Curr Opin Organ Transplant, 2014, 19 (4): 387-394. doi: 10.1097/MOT.0000000000000093
    [11]
    Gupta A, Kumer S, Kaplan B. Novel immunosuppressive strategies for composite tissue allografts[J]. Curr Opin Organ Transplant, 2014, 19(6): 552-557. doi: 10.1097/MOT.0000000000000135
    [12]
    Geissler EK. The influence of mTOR inhibitors on immunity and the relationship to posttransplant malignancy[J]. Transplant Res, 2013, 2 (Suppl 1): S2. doi: 10.1186/2047-1440-2-S1-S2
    [13]
    Klintmalm GB, Feng S, Lake JR, et al. Belatacept-based immunosuppression in de novo liver transplant recipients:1-year experience from a phase II randomized study[J]. Am J Transplant, 2014, 14(8):1817-1827. doi: 10.1111/ajt.12810
    [14]
    Tang CY, Shen A, Wei XF, et al. Everolimus in de novo liver transplant recipients: a systematic review[J]. Hepatobiliary Pancreat Dis Int, 2015, 14(5): 461-469. doi: 10.1016/S1499-3872(15)60419-2
    [15]
    Diekmann F. Immunosuppressive minimization with mTOR inhibitors and belatacept[J]. Transpl Int, 2015, 28(8):921-927. doi: 10.1111/tri.2015.28.issue-8
    [16]
    Kamar N, Rostaing L, Cassuto E, et al. A multicenter, randomized trial of increased mycophenolic acid dose using enteric-coated mycophenolate sodium with reduced tacrolimus exposure in maintenance kidney transplant recipients[J].Clin Nephrol, 2012, 77(2):126-136. doi: 10.5414/CN107227
    [17]
    Hao JC, Wang WT, Yan LN, et al. Effect of low-dose tacrolimus with mycophenolate mofetilon renal function following liver transplantation[J]. World J Gastroenterol, 2014, 20(32): 11356-11362. doi: 10.3748/wjg.v20.i32.11356
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (127) PDF downloads(10) Cited by()
    Proportional views
    Related

    WeChat Subscription Account

    Wechat Service Account

    Contact Us
    • Tel：020-38736410
    • Email: organtranspl@163.com
    • Address：The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou
    • Editorial Office of Organ Transplantation  粤ICP备2021030844号
    Links

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return