Journal article
Reduction of CMV disease with steroid-free immunosuppresssion in simultaneous pancreas-kidney transplant recipients
American journal of transplantation, Vol.5(6), pp.1423-1429
2005
DOI: 10.1111/j.1600-6143.2005.00855.x
PMID: 15888050
Abstract
The impact of a prednisone-free immunosuppressive regimen was evaluated in simultaneous pancreas-kidney (SPK) recipients. Patient and graft survivals, rejection rates and the incidence of CMV disease were determined. Two hundred consecutive SPK transplant recipients received tacrolimus-based immunosuppression with (n = 100) or without (n = 100) chronic prednisone therapy. Patients were induced with lymphocyte depleting antibodies or IL-2 receptor blockers and received prophylactic antiviral therapy. Patient and graft survivals and rejection rates were not statistically significantly different between treatment groups. Two-year cumulative incidence of CMV in recipients in the prednisone-free protocol was reduced (7.2% vs. 16%; p = 0.15). Considering only recipients at highest risk (D+/R- or D+R+), incidence of CMV disease in the prednisone-free group (n = 61) compared to the steroid-treated group (n = 48) was reduced from 36% to 18% (p < 0.05). Multivariate analysis confirmed the independent effect of prednisone treatment on the incidence of CMV (RR 2.3; p = 0.04). In the prednisone-free protocol, incidence of CMV was less frequent in recipients receiving induction with Campath versus rabbit antilymphocyte globulin (2.4% vs. 12.6%; p = 0.14). Eliminating prednisone immunotherapy did not adversely affect outcomes and was associated with a reduced rate of CMV in SPK recipients of organs from sero-positive donors. Copyright © Blackwell Munksgaard 2005.
Details
- Title: Subtitle
- Reduction of CMV disease with steroid-free immunosuppresssion in simultaneous pancreas-kidney transplant recipients
- Creators
- David Axelrod - Northwestern UniversityJoseph R Leventhal - Northwestern UniversityLorenzo G Gallon - Northwestern UniversityMichele A Parker - Duke Cardiovascular Magnetic Resonance Center, Duke University Medical Center, Durham, North CarolinaDixon B Kaufman - Northwestern University
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.5(6), pp.1423-1429
- Publisher
- Blackwell
- DOI
- 10.1111/j.1600-6143.2005.00855.x
- PMID
- 15888050
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Language
- English
- Date published
- 2005
- Academic Unit
- Surgery
- Record Identifier
- 9984322813802771
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