TY - JOUR
T1 - Three-yr safety and efficacy of everolimus and low-dose cyclosporine in de novo pediatric kidney transplant patients
AU - Ferraresso, Mariano
AU - Belingheri, Mirco
AU - Ginevri, Fabrizio
AU - Murer, Luisa
AU - Dello Strologo, Luca
AU - Cardillo, Massimo
AU - Parodi, Angelica
AU - Ghirardo, Giulia
AU - Guzzo, Isabella
AU - Innocente, Annalisa
AU - Ghio, Luciana
PY - 2014
Y1 - 2014
N2 - The three yr results of a multicenter trial in de novo pediatric KT treated with a proliferative signal inhibitor and low dose CNI are presented. Thirty-seven children (9.1 ± 5 yr old) received basiliximab, cyclosporine A (CyA C2:1400 ng/mL), (MMF C0:1.5-3 μg/mL), and prednisone. Three wk later everolimus was started (C0:5-10 ng/mL), CyA was reduced (C2:600 ng/mL after 90 days 300 ng/mL), and MMF discontinued. During the three-yr period patient and graft survivals were 96%. One patient died for causes unrelated to the immunosuppression. Cumulative acute rejection rate including protocol and indication biopsies was 21.9%. None of the patients had signs of chronic humoral rejection. Incidence of dnDSA was 5%, 11%, and 22% at one, two, and three yr post-transplant, respectively. Mean glomerular filtration rate measured at one yr and three yr post-transplant was 105.5 ± 31 and 110.7 ± 27 mL/min/1.73 m2, respectively. A growth velocity of 7.7 ± 6.7 cm/yr was achieved with positive catch-up growth. No malignancy or post-transplant lymphoproliferative diseases were diagnosed. In conclusion, the treatment based on basiliximab induction, everolimus, low-dose cyclosporine, and low-dose prednisone leads to good long-term efficacy in de novo pediatric KT recipients.
AB - The three yr results of a multicenter trial in de novo pediatric KT treated with a proliferative signal inhibitor and low dose CNI are presented. Thirty-seven children (9.1 ± 5 yr old) received basiliximab, cyclosporine A (CyA C2:1400 ng/mL), (MMF C0:1.5-3 μg/mL), and prednisone. Three wk later everolimus was started (C0:5-10 ng/mL), CyA was reduced (C2:600 ng/mL after 90 days 300 ng/mL), and MMF discontinued. During the three-yr period patient and graft survivals were 96%. One patient died for causes unrelated to the immunosuppression. Cumulative acute rejection rate including protocol and indication biopsies was 21.9%. None of the patients had signs of chronic humoral rejection. Incidence of dnDSA was 5%, 11%, and 22% at one, two, and three yr post-transplant, respectively. Mean glomerular filtration rate measured at one yr and three yr post-transplant was 105.5 ± 31 and 110.7 ± 27 mL/min/1.73 m2, respectively. A growth velocity of 7.7 ± 6.7 cm/yr was achieved with positive catch-up growth. No malignancy or post-transplant lymphoproliferative diseases were diagnosed. In conclusion, the treatment based on basiliximab induction, everolimus, low-dose cyclosporine, and low-dose prednisone leads to good long-term efficacy in de novo pediatric KT recipients.
KW - acute rejection
KW - cyclosporine
KW - donor specific antibodies
KW - everolimus
KW - long term results
KW - pediatric kidney transplantation
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UR - http://www.scopus.com/inward/citedby.url?scp=84900011637&partnerID=8YFLogxK
U2 - 10.1111/petr.12261
DO - 10.1111/petr.12261
M3 - Article
C2 - 24802342
AN - SCOPUS:84900011637
VL - 18
SP - 350
EP - 356
JO - Pediatric Transplantation
JF - Pediatric Transplantation
SN - 1397-3142
IS - 4
ER -