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- W3023218561 abstract "Two hundred and forty-four cardiac transplant patients (191 male; mean age 47[range 18–67] years) were treated with either mycophenolate mofetil (MMF) or azathioprine (AZA) both in combination with cyclosporine (CsA) and corticosteroids after Rabbit Antithymocyte Globulin induction; N=119 MMF (August 2000–August 2004) and N=125 AZA (August 1997–July 2000). By protocol, lower cyclosporine levels (parent compound in whole blood by HPLC mass spectrometry) were targeted in the MMF group, CsA levels were lower at 3 months (MMF 236±SEM 7 vs. AZA 260±7 ng/ml p=0.006) and 6 months (209±8 vs. 231±6 p=0.006) in the MMF group. Patient survival at one- (81% vs. 80%) and three-years was similar in each group (p=0.77, log rank test). In patients who survived for 1-year (n=198) the cumulative probability of receiving anti-rejection treatment was less in the MMF group (48% vs. 67% p<0.01) as was the incidence of biopsy proven ISHLT ≥3a acute rejection (26%vs 34%). In the MMF group, there were fewer cases of steroid resistant rejection requiring cytolytic therapy (4% vs 12% p =0.03) and more patients were weaned off steroids by 1 year (63% vs. 36% p=<0.001). Renal function was better in the MMF group with lower creatinine levels at 6 months (131±5vs144±5μmol/l p=0.006) and 1-year (139 ±5vs156 ±5 μmol/ p=0.005). Calculated creatinine clearance (Cockroft and Gault) at 1-year was higher in the MMF group (81 ±4 vs 70 ±3 mls/min p=0.02).Left ventricular ejection fraction was similar in both groups (75±0.6 vs. 73.5±0.5% p=0.14) at 1 year. Immunosuppression with mycophenolate mofetil rather then azathoprine allowed better control of acute rejection despite lower cyclosporine levels and resulted in better renal function and increased steroid weaning at 1-year." @default.
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- W3023218561 date "2006-02-01" @default.
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- W3023218561 doi "https://doi.org/10.1016/j.healun.2005.11.367" @default.
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