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- W2032865737 abstract "P192 Aims: CsA/SRL combination may result in impaired graft function and may therefore be associated with reduced long-term graft survival. Conversion from CsA to MMF may improve graft function while providing sufficient protection against acute graft rejection. Methods: Between 25/08/99 and 30/10/2002, 182 patients received CsA/SRL/PRED combination. Of them 81 (44.5%) were converted to MMF/SRL combination due to chronic allograft dysfunction. Demographics, immunosuppression, graft function, hematology and biochemistry were obtained pre-conversion (-6, -3, and -1 month) and 1, 3, 6, 9 and 12 months post-conversion. On the day of conversion CsA was replaced by MMF (500 mg BID) without an overlap period. Patients not taking steroids received 1g BID of MMF. Results: Mean age was 37±12 years, 78% males, 31% caucasian and 96.3% living-donor allograft recipients. Mean time to conversion was 27±11 months. Cumulative incidence of biopsy-confirmed acute rejection prior to conversion was 28.4%. At the time of conversion CsA, SRL, and PRED doses were 93±84 mg/day, 3.6 ± 2.6 mg/day and 7.8±5.4 mg/day, respectively, and 35% of patients were off steroids. Corresponding CsA and SRL trough concentrations were 45±40 ng/mL and 8.4±8.1 ng/mL, respectively. Mean follow-up time after conversion was 6.5±5.1 months. Mean creatinine at the time of conversion was 2.1±1.02 mg/dL. A significant improvement in graft function was observed using linear regression analysis (1/Cr vs. time) and comparing the slopes observed pre- and post-conversion [-0.0027±0.0495 (R2=0.495±0.342) vs. 0.0454 ± 0.092 (R2=0.641±0.354) mg-1.dL.day-1, p< 0.001]. One month after conversion, a significant decrease in mean systolic blood pressure (139±18 vs. 133±22, p=0.03) and triglyceride (400± 228 vs. 244± 99, p=0.026) concentrations were observed. There were no episodes of acute rejection, graft loss or death. The combination of SRL and MMF was well tolerated. There were 8 MMF dose reductions (5 due to diarrhea, 1 due to anemia and 1 due to pruritus). There were 32 episodes of infections (18 bacterial, 8 viral, 5 fungal and 1 parasitic) and no malignancies. Conclusions: Conversion from cyclosporine/sirolimus (CsA/SRL) to mycophenolate mofetil/sirolimus (MMF/SRL) in patients with chronic allograft dysfunction is a potential effective and safe strategy to preserve graft function." @default.
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- W2032865737 date "2004-07-01" @default.
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- W2032865737 title "CONVERSION FROM CYCLOSPORINE/SIROLIMUS (CSA/SRL) TO MYCOPHENOLATE MOFETIL/SIROLIMUS (MMF/SRL) IN PATIENTS WITH CHRONIC ALLOGRAFT DYSFUNCTION" @default.
- W2032865737 doi "https://doi.org/10.1097/00007890-200407271-00688" @default.
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