The aim of the study was to evaluate safety and efficacy of everolimus with cyclosporine (CsA) in de novo renal transplant recipients. The immunosuppressive regimen, including basiliximab, everolimus (3 mg), and low-dose CsA, was administered to 17 patients, of whom 15 were part of a multicenter randomized study that stipulated cessation of steroids at 7 days posttransplantation in 5 recipients. Five patients underwent dialysis after transplantation for delayed graft function (DGF; 29%), all of whom showed a good recovery within 3 weeks. The mean follow-up was 45.7 months (SD +/- 13). The 1-year graft survival was 100%. We observed one acute rejection episode. No patient experienced a cytomegalovirus infection. Increased cholesterol and triglyceride levels were reported in almost all patients. Severe arthralgia (n = 3) was treated by everolimus dose reduction to maintain trough levels at 3 ng/mL. We noted a high rate of switch to mycophenolate mofetil (MMF) throughout follow-up (n = 7), due to everolimus-induced side effects. However, we did not observe normalization of lipids after the switch: patients always required stain treatment, resulting in slightly lower serum cholesterol and triglycerides. Everolimus plus CsA was effective to prevent acute rejection after kidney transplantation. To manage the induced side effects of the drugs C-2 monitoring is mandatory, targeting 350 ng/mL during 1 year and 200 to 250 ng/mL thereafter. Careful reduction of everolimus trough levels to 3 ng/mL is recommended for patients with arthralgia.

Iaria, G., Pisani, F., Iorio, B., Lucchesi, C., De Luca, L., Ielpo, B., et al. (2006). Long-term results of kidney transplantation with cyclosporine- and everolimus-based immunosuppression. In Transplantation proceedings (pp.1018-1019). NEW YORK : Elsevier [10.1016/j.transproceed.2006.04.001].

Long-term results of kidney transplantation with cyclosporine- and everolimus-based immunosuppression

IORIO, BENIAMINO;TISONE, GIUSEPPE
2006-05-01

Abstract

The aim of the study was to evaluate safety and efficacy of everolimus with cyclosporine (CsA) in de novo renal transplant recipients. The immunosuppressive regimen, including basiliximab, everolimus (3 mg), and low-dose CsA, was administered to 17 patients, of whom 15 were part of a multicenter randomized study that stipulated cessation of steroids at 7 days posttransplantation in 5 recipients. Five patients underwent dialysis after transplantation for delayed graft function (DGF; 29%), all of whom showed a good recovery within 3 weeks. The mean follow-up was 45.7 months (SD +/- 13). The 1-year graft survival was 100%. We observed one acute rejection episode. No patient experienced a cytomegalovirus infection. Increased cholesterol and triglyceride levels were reported in almost all patients. Severe arthralgia (n = 3) was treated by everolimus dose reduction to maintain trough levels at 3 ng/mL. We noted a high rate of switch to mycophenolate mofetil (MMF) throughout follow-up (n = 7), due to everolimus-induced side effects. However, we did not observe normalization of lipids after the switch: patients always required stain treatment, resulting in slightly lower serum cholesterol and triglycerides. Everolimus plus CsA was effective to prevent acute rejection after kidney transplantation. To manage the induced side effects of the drugs C-2 monitoring is mandatory, targeting 350 ng/mL during 1 year and 200 to 250 ng/mL thereafter. Careful reduction of everolimus trough levels to 3 ng/mL is recommended for patients with arthralgia.
Congress of the Italian society of organ transplantation
Palermo (Italy)
2005
29.
Italian society of organ transplantation
Rilevanza nazionale
contributo
Settore MED/18 - Chirurgia Generale
English
basiliximab; corticosteroid; cyclosporin A; everolimus; lipid; mycophenolic acid 2 morpholinoethyl ester; steroid; tacrolimus; adult; aged; arthralgia; article; cholesterol blood level; clinical article; cytomegalovirus infection; dialysis; drug dose reduction; drug efficacy; drug monitoring; drug safety; female; follow up; graft survival; human; hyperlipidemia; immunosuppressive treatment; kidney graft; kidney graft rejection; kidney transplantation; lipid blood level; long term care; male; outcome assessment; priority journal; renal graft dysfunction; staining; triacylglycerol blood level; Adult; Aged; Cyclosporine; Drug Therapy, Combination; Female; Follow-Up Studies; Graft Survival; Humans; Immunosuppressive Agents; Kidney Diseases; Kidney Transplantation; Male; Middle Aged; Sirolimus; Time Factors
Intervento a convegno
Iaria, G., Pisani, F., Iorio, B., Lucchesi, C., De Luca, L., Ielpo, B., et al. (2006). Long-term results of kidney transplantation with cyclosporine- and everolimus-based immunosuppression. In Transplantation proceedings (pp.1018-1019). NEW YORK : Elsevier [10.1016/j.transproceed.2006.04.001].
Iaria, G; Pisani, F; Iorio, B; Lucchesi, C; De Luca, L; Ielpo, B; D'Andria, D; Tariciotti, L; Tisone, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/29096
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