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.
Author
Wali, Ravinder KPrentice, Heather A
Reddivari, Venkata
Baffoe-Bonnie, Geroge
Drachenberg, Cinthia I
Pappadimitriou, John C
Ramos, Emilio
Cooper, Matthew
Jonsson, Johann
Bartlett, Stephen
Weir, Matthew R
Date
2016-08-11Journal
Transplantation DirectPublisher
Wolters Kluwer HealthType
Article
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Show full item recordAbstract
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/10713/18794ae974a485f413a2113503eed53cd6c53
10.1097/TXD.0000000000000585
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