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    Early Kidney Allograft Dysfunction (Threatened Allograft): Comparative Effectiveness of Continuing Versus Discontinuation of Tacrolimus and Use of Sirolimus to Prevent Graft Failure: A Retrospective Patient-Centered Outcome Study.

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    Author
    Wali, Ravinder K
    Prentice, Heather A
    Reddivari, Venkata
    Baffoe-Bonnie, Geroge
    Drachenberg, Cinthia I
    Pappadimitriou, John C
    Ramos, Emilio
    Cooper, Matthew
    Jonsson, Johann
    Bartlett, Stephen
    Weir, Matthew R
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    Date
    2016-08-11
    Journal
    Transplantation Direct
    Publisher
    Wolters Kluwer Health
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1097/TXD.0000000000000585
    Abstract
    Weighted odds for death-censored graft failure (odds ratio [OR], 1.20; 95% confidence interval [95% CI], 0.66-2.19, P = 0.555) was similar in the 2 groups, but a trend for increased risk of greater than 50% loss in estimated glomerular filtration rate from baseline in sirolimus group (OR, 1.90; 95% CI, 0.96-3.76; P = 0.067) compared with tacrolimus group. Sirloimus group compared with tacrolimus group had increased risk for death with functioning graft (OR, 2.01; 95% CI, 1.29-3.14; P = 0.002) as well as increased risk of late death (death after graft failure while on dialysis) (OR, 2.39; 95% CI, 1.59-3.59; P < 0.001). Analysis of subgroups based on the absence or presence of T cell-mediated rejection or tubulointerstitial inflammation in the index biopsy, or the use of different types of induction agents, and all subgroups had increased risk of death with functioning graft and late death if exposed to sirolimus-based therapy.
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18794
    ae974a485f413a2113503eed53cd6c53
    10.1097/TXD.0000000000000585
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