Conversion to sirolimus-based maintenance immunosuppression using daclizumab bridge therapy in renal transplant recipients

Clinical Transplantation
Aimee K SundbergRobert J Stratta

Abstract

Conversion from calcineurin inhibitor (CI)-based maintenance immunosuppression to sirolimus (SRL)-based immunosuppression may be beneficial in selected renal transplant recipients. The purpose of this study was to evaluate the safety and efficacy of a daclizumab (DAC) bridge protocol in patients converted from CI- to SRL-based maintenance immunosuppression. We conducted a retrospective chart review of renal transplant recipients who were converted to SRL at least 2 months post-transplant. The protocol consisted of an abrupt discontinuation of either cyclosporin (CsA) or tacrolimus (TAC), initiation of SRL within 48 h of CI discontinuation, and DAC 2 mg/kg at the time of CI discontinuation and again at 14 d (depending on the SRL serum concentration). The SRL starting dose was based on risk stratification in each patient. Twenty-one renal transplant patients were converted to SRL (11 from TAC, 10 from CsA) between October 2001 and July 2003. Conversion occurred at a mean of 23 months post-transplant. Indications for SRL conversion included 12 for chronic allograft nephropathy (CAN), four for CI-associated neurotoxicity, two for thrombotic microangiopathy (TMA), two for post-transplant diabetes mellitus (PTDM), and one for polyoma...Continue Reading

References

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Citations

Jan 12, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·M Colleen HastingsLillian W Gaber
Sep 24, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Josef FangmannUNKNOWN DACH Study Group
Sep 29, 2011·Current Opinion in Nephrology and Hypertension·Beatriz Domínguez-GilJose M Morales
Aug 10, 2010·Transplantation Proceedings·V A KirchnerR Kandaswamy
Feb 20, 2008·Pediatric Transplantation·Leonard C HymesLarry A Greenbaum
Jun 20, 2008·Pediatric Transplantation·Lauren WeintraubMinnie Sarwal

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