Effect of long-term immunosuppression in kidney-graft recipients on cancer incidence: randomised comparison of two cyclosporin regimens

@article{Dantal1998EffectOL,
  title={Effect of long-term immunosuppression in kidney-graft recipients on cancer incidence: randomised comparison of two cyclosporin regimens},
  author={Jacques Dantal and Maryvonne Hourmant and Diego Cantarovich and Magali Giral and Gilles Blancho and Brigitte Dr{\'e}no and Jean Paul Soulillou},
  journal={The Lancet},
  year={1998},
  volume={351},
  pages={623-628}
}
Long-term outcome of conversion to sirolimus monotherapy after liver transplant.
  • D. Uhlmann, T. Weber, H. Witzigmann
  • Medicine
    Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
  • 2012
TLDR
Conversion from calcineurin inhibitors to sirolimus monotherapy after liver transplant results in stabilization of renal function in 75% to 85% of cases and of blood pressure, without increased risk of rejection.
Cyclosporin Maintenance Monotherapy After Renal Transplantation
TLDR
Maintenance cyclosporin monotherapy is feasible and probably useful in selected primary graft recipients without deleterious effects on overall results, and a low incidence of nonmelanoma skin cancers and of squamous-cell carcinoma in this series is encouraging.
Factors Associated With Long-Term Renal Allograft Survival
TLDR
The evidence supporting the role of therapeutic drug monitoring as applied to commonly used immunosuppressants in modern transplantation is presented here, and the increasing role of Therapeutic drug monitoring in the optimization of graft and patient survival rates in the modern era of renal transplation is discussed.
Causes of late transplant failure in cyclosporine-treated kidney allograft recipients
TLDR
Prolonged use of cyclosporine may expose to several dose-related adverse events and may contribute to the development of allograft dysfunction but it does not necessarily cause relentless, progressive transplant failure if patients are carefully and consistently monitored during the follow-up.
Randomized Study Comparing Cyclosporine With Azathioprine One Year After Renal Transplantation–15-Year Outcome Data
TLDR
Despite lower estimated glomerular filtration rate (eGFR) up to 10 years posttransplantation and increased use of anti-hypertensive agents, low-dose CsA was not associated with a worse patient or graft survival.
Long-term results of a prospective randomized study comparing two immunosuppressive regimens, one with and one without CsA, in low-risk renal transplant recipients
  • P. Grimbert, C. Baron, P. Lang
  • Medicine
    Transplant international : official journal of the European Society for Organ Transplantation
  • 2002
TLDR
It is concluded that a 12-year graft survival of 56% and a graft half-life of 15 years can be achieved without the primary use of a calcineurin inhibitor in low-risk patients receiving ALG.
Costimulation blockade with belatacept in renal transplantation.
TLDR
Belatacept, an investigational selective costimulation blocker, did not appear to be inferior to cyclosporine as a means of preventing acute rejection after renal transplantation and may preserve the glomerular filtration rate and reduce the rate of chronic allograft nephropathy.
Can we minimize the long-term side effects of immunosuppressive drugs in pediatric patients?
TLDR
It is important, therefore, to develop immunosup-pressive protocols that are adjusted to the specific needs of a growing child, particularly for children who are likely to receive immuno-suppressive therapy for several decades.
Long-term cancer risk of immunosuppressive regimens after kidney transplantation.
TLDR
These immunosuppressive regimens, widely used in recent decades, carry similar risks for carcinogenicity after kidney transplantation, and treatment allocation did not associate with development of either form of cancer in multivariate analyses.
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The majority of renal-transplant patients tolerate long-term cyclosporine therapy without evidence of progressive toxic nephropathy, and most patients with functioning grafts at one year had first episodes of rejection more than one year after transplantation.
Effect of the maintenance immunosuppressive drug regimen on kidney transplant outcome.
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It is suggested that discontinuation of steroid therapy should be attempted in renal transplant recipients after they have experienced several months of stable graft function on triple-drug immunosuppression.
THE IMPACT OF ACUTE REJECTION EPISODES ON LONG‐TERM GRAFT FUNCTION AND OUTCOME IN 1347 PRIMARY RENAL TRANSPLANTS TREATED BY 3 CYCLOSPORINE REGIMENS
TLDR
Although the incidence of first acute rejection was similar in CD and LD patients, it was successfully reversed by antirejection treatment in a higher percentage in LD patients and the estimated graft half-life was shorter in patients who had acute rejection episodes than those who did not.
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TLDR
The current literature about this subject will be analyzed and its presumed pathogenesis will be reviewed with an emphasis on recent studies indicating that cyclosporine-induced renal fibrosis may be an inevitable consequence of effective immunosuppressive therapy.
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TLDR
The increased incidence of acute rejection following elective cyclosporine withdrawal does not affect short-term graft or patient survival after renal transplantation and whether long-term consequences will outweigh the benefits of elective withdrawal remains to be determined.
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TLDR
MMF is associated with a significantly lower rate of treatment failure compared with AZA during the first 6 months after renal transplantation and produces a clinically important reduction in the incidence, severity, and treatment of acute graft rejection.
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TLDR
The results indicate that the efficacy and safety of FK506 were comparable to that for cyclosporine for primary immunosuppression in patients undergoing cadaveric kidney transplantation.
Occurrence of cancers in immunosuppressed organ transplant recipients.
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TLDR
The findings in this study emphasize the need for lifetime follow-up of organ transplant recipients and the need to modify the present blunderbuss attack on the immune system with more specific methods of control.
Anti-CD4 MoAb therapy in kidney transplantation--a pilot study in early prophylaxis of rejection.
TLDR
Although the biological parameters indicate an action of B-F5 in vivo, the clinical data associated with poor MoAb bioavailability suggest the need for an improved pharmacokinetic behavior of the MoAb to determine its use for prophylaxis of early rejection.
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