Three-yr safety and efficacy of everolimus and low-dose cyclosporine in de novo pediatric kidney transplant patients

Mariano Ferraresso, Mirco Belingheri, Fabrizio Ginevri, Luisa Murer, Luca Dello Strologo, Massimo Cardillo, Angelica Parodi, Giulia Ghirardo, Isabella Guzzo, Annalisa Innocente, Luciana Ghio

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)350-356
Number of pages7
JournalPediatric Transplantation
Volume18
Issue number4
DOIs
Publication statusPublished - 2014

Fingerprint

Cyclosporine
Pediatrics
Prednisone
Transplants
Kidney
Safety
Graft Survival
Growth
Glomerular Filtration Rate
Immunosuppression
Multicenter Studies
Biopsy
Incidence
Everolimus
Neoplasms
basiliximab
Therapeutics

Keywords

  • acute rejection
  • cyclosporine
  • donor specific antibodies
  • everolimus
  • long term results
  • pediatric kidney transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation
  • Medicine(all)

Cite this

Three-yr safety and efficacy of everolimus and low-dose cyclosporine in de novo pediatric kidney transplant patients. / Ferraresso, Mariano; Belingheri, Mirco; Ginevri, Fabrizio; Murer, Luisa; Dello Strologo, Luca; Cardillo, Massimo; Parodi, Angelica; Ghirardo, Giulia; Guzzo, Isabella; Innocente, Annalisa; Ghio, Luciana.

In: Pediatric Transplantation, Vol. 18, No. 4, 2014, p. 350-356.

Research output: Contribution to journalArticle

Ferraresso, Mariano ; Belingheri, Mirco ; Ginevri, Fabrizio ; Murer, Luisa ; Dello Strologo, Luca ; Cardillo, Massimo ; Parodi, Angelica ; Ghirardo, Giulia ; Guzzo, Isabella ; Innocente, Annalisa ; Ghio, Luciana. / Three-yr safety and efficacy of everolimus and low-dose cyclosporine in de novo pediatric kidney transplant patients. In: Pediatric Transplantation. 2014 ; Vol. 18, No. 4. pp. 350-356.
@article{3939f69bf801468aadfe815c6f6bd730,
title = "Three-yr safety and efficacy of everolimus and low-dose cyclosporine in de novo pediatric kidney transplant patients",
abstract = "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.",
keywords = "acute rejection, cyclosporine, donor specific antibodies, everolimus, long term results, pediatric kidney transplantation",
author = "Mariano Ferraresso and Mirco Belingheri and Fabrizio Ginevri and Luisa Murer and {Dello Strologo}, Luca and Massimo Cardillo and Angelica Parodi and Giulia Ghirardo and Isabella Guzzo and Annalisa Innocente and Luciana Ghio",
year = "2014",
doi = "10.1111/petr.12261",
language = "English",
volume = "18",
pages = "350--356",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "4",

}

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

UR - http://www.scopus.com/inward/record.url?scp=84900011637&partnerID=8YFLogxK

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 -