Early conversion to a CNI-free immunosuppression with SRL after renal transplantation-Long-term follow-up of a multicenter trial
Andrassy J, Guba M, Habicht A, Fischereder M, Pratschke J, Pascher A, Heller KM, Banas B, Hakenberg O, Vogel T, Meiser B, Dick A, Werner J, Kauke T (2020)
Publication Type: Journal article
Publication year: 2020
Journal
Book Volume: 15
Pages Range: e0234396-
Journal Issue: 8
DOI: 10.1371/journal.pone.0234396
Abstract
INTRODUCTION: Early conversion to a CNI-free immunosuppression with SRL was associated with an improved 1- and 3- yr renal function as compared with a CsA-based regimen in the SMART-Trial. Mixed results were reported on the occurrence of donor specific antibodies under mTOR-Is. Here, we present long-term results of the SMART-Trial. METHODS AND MATERIALS: N = 71 from 6 centers (n = 38 SRL and n = 33 CsA) of the original SMART-Trial (ITT n = 140) were enrolled in this observational, non-interventional extension study to collect retrospectively and prospectively follow-up data for the interval since baseline. Primary objective was the development of dnDSA. Blood samples were collected on average 8.7 years after transplantation. RESULTS: Development of dnDSA was not different (SRL 5/38, 13.2% vs. CsA 9/33, 27.3%; P = 0.097). GFR remained improved under SRL with 64.37 ml/min/1.73m2 vs. 53.19 ml/min/1.73m2 (p = 0.044). Patient survival did not differ between groups at 10 years. There was a trend towards a reduced graft failure rate (11.6% SRL vs. 23.9% CsA, p = 0.064) and less tumors under SRL (2.6% SRL vs. 15.2% CsA, p = 0.09). CONCLUSIONS: An early conversion to SRL did not result in an increased incidence of dnDSA nor increased long-term risk for the recipient. Transplant function remains improved with benefits for the graft survival.
Involved external institutions
Westfälische Wilhelms-Universität (WWU) Münster
Germany (DE)
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
Charité - Universitätsmedizin Berlin
Germany (DE)
Universitätsklinikum Regensburg
Germany (DE)
Universität Rostock
Germany (DE)
Germany (DE)
Ludwig-Maximilians-Universität (LMU)
Germany (DE)
Charité - Universitätsmedizin Berlin
Germany (DE)
Universitätsklinikum Regensburg
Germany (DE)
Universität Rostock
Germany (DE)
How to cite
APA:
Andrassy, J., Guba, M., Habicht, A., Fischereder, M., Pratschke, J., Pascher, A.,... Kauke, T. (2020). Early conversion to a CNI-free immunosuppression with SRL after renal transplantation-Long-term follow-up of a multicenter trial. PLoS ONE, 15(8), e0234396-. https://doi.org/10.1371/journal.pone.0234396
MLA:
Andrassy, Joachim, et al. "Early conversion to a CNI-free immunosuppression with SRL after renal transplantation-Long-term follow-up of a multicenter trial." PLoS ONE 15.8 (2020): e0234396-.
BibTeX: Download