Thymoglobulin Induction and Sirolimus Versus Tacrolimus in Kidney Transplant Recipients Receiving Mycophenolate Mofetil and Steroids
Thymoglobulin Induction and Sirolimus Versus Tacrolimus in Kidney Transplant Recipients Receiving Mycophenolate Mofetil and Steroids
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DOI：
10.1097/tp.0b013e3181db09e4
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发表时间：
2010-06-27
期刊：
影响因子：
6.2
通讯作者：
Lefrancois, Nicole
中科院分区：
文献类型：
--
作者：
Glotz, Denis;Charpentier, Bernard;Lefrancois, Nicole
背景资料。为了明确雷帕霉素抑制剂的哺乳动物靶点在肾移植中的作用，我们比较了两种免疫抑制方案-无钙调神经磷酸酶抑制剂耗竭诱导方案和以钙调神经磷酸酶抑制剂为基础的方案的有效性和安全性。肾移植受者于移植前随机分为西罗莫司组(A组，n=71)和他克莫司组(B组，n=70)。所有患者均接受霉酚酸酯和皮质类固醇治疗。A组为兔抗胸腺细胞球蛋白诱导组。B组移植肾功能延迟时可给予抗胸腺细胞球蛋白治疗。12个月时估计的肾小球滤过率(GFR)(南基维尔公式)是主要终点。12个月时肾小球滤过率A组为56.1，B组为58.4mL/min/1.73 m(2)，差异无统计学意义(P>0.05)。
Background. To define the role of mammalian target of rapamycin inhibitors in kidney transplantation, we compared efficacy and safety of two immunosuppressive regimens-a calcineurin inhibitor-free regimen with depletive induction versus a calcineurin inhibitor-based regimen.Methods. De novo renal allograft recipients were randomized before transplantation to receive sirolimus (SRL; n=71, group A) or tacrolimus (n=70, group B). All patients received mycophenolate mofetil and corticosteroids. In group A, patients received rabbit antithymocyte globulin induction. In group B, antithymocyte globulin therapy could be given in case of delayed graft function. The estimated glomerular filtration rate (GFR) (Nankivell's formula) at month 12 was the primary endpoint.Results. GFR showed no significant difference at month 12, with 56.1 in group A versus 58.4 mL/min/1.73 m(2) in group B. In functioning grafts, renal function was significantly better in the SRL group, with higher GFR values at months 1, 2, 3, 6, and 9 (P