National Variation in Use of Immunosuppression for Kidney Transplantation: A Call for Evidence-Based Regimen Selection.
National Variation in Use of Immunosuppression for Kidney Transplantation: A Call for Evidence-Based Regimen Selection.
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DOI：
10.1111/ajt.13758
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发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Lentine KL
中科院分区：
文献类型：
--
作者：
Axelrod DA;Naik AS;Schnitzler MA;Segev DL;Dharnidharka VR;Brennan DC;Bae S;Chen J;Massie A;Lentine KL
Immunosuppression management in kidney transplantation has evolved to include an increasingly diverse choice of medications. While informed by patient and donor characteristics, choice of immunosuppression regimen varies widely across transplant programs. Using a novel database integrating national transplant registry and pharmacy fill records, immunosuppression use 6–12 and 12–24 months post-transplant was evaluated for 22,453 patients transplanted at 249 U.S. programs in 2005–2010. Use of triple immunosuppression comprising tacrolimus, mycophenolic acid or azathioprine, and steroids varied widely (0–100% of patients per program), as did use of steroid-sparing regimens (0–77%), in sirolimus-based regimens (0–100%) and cyclosporine-based regimens (0–78%). Use of triple therapy was more common in highly sensitized patients, women, and recipients with dialysis duration > 5 years. Sirolimus use appeared to diminish over the study period. Overall, patient and donor characteristics explained only a limited amount of the observed variation in regimen use, while center choice explained 30–46% of the use of non-triple therapy immunosuppression. The majority of patients who received triple therapy (79%), cyclosporine-based (87.6%) and sirolimus-based regimens (84.3%) continued these regimens in the second year post-transplant. This population-based study of immunosuppression practice demonstrates substantial variation in center practice beyond that is explained by differences in patient and donor characteristics.
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影响因子：
13.6
作者：
Lentine, KL;Brennan, DC;Schnitzler, MA
通讯作者：
Schnitzler, MA
DOI：
10.2215/cjn.03080707
发表时间：
2008-07-01
影响因子：
9.8
作者：
Lentine, Krista L.;Rey, Lisa A. Rocca;Brennan, Daniel C.
通讯作者：
Brennan, Daniel C.
影响因子：
19.6
作者：
Weir, Matthew R.;Mulgaonkar, Shamkant;Pearson, Thomas C.
通讯作者：
Pearson, Thomas C.
影响因子：
13.6
作者：
Stirnemann, Paula M.;Takemoto, Steven K.;Lentine, Krista L.
通讯作者：
Lentine, Krista L.
影响因子：
6.2
作者：
Lentine, Krista L.;Gheorghian, Adrian;Schnitzler, Mark A.
通讯作者：
Schnitzler, Mark A.