Outcomes of sirolimus regimens in 65-year-old and older kidney transplant recipients: a registry-based observational study

International Urology and Nephrology
Alfonso H SantosXuerong Wen

Abstract

In large observational studies of adult kidney transplant recipients (KTRs) where older adults (65 years old and older) were not well represented, the mammalian target of rapamycin inhibitors (mTOR inhibitors) has poorer outcomes than the standard tacrolimus-mycophenolate-steroids (TAC-MPA-S) regimen. We conducted this study to compare the outcomes of regimens containing the common mTOR inhibitor, sirolimus (SRL) against TAC-MPA-S in older adult KTRs. Using the 2000-2016 Scientific Registry of Transplant Recipients, Cox multivariable regression models were conducted to analyze the patient and graft outcomes associated with regimens containing SRL, steroids (S) and cyclosporine (CSA), tacrolimus (TAC), or mycophenolate (MPA) vs. the standard (TAC-MPA-S) regimen in older adult KTRs. Included in the analysis were 15,008 (95.19%) older adult KTRs on standard (TAC-MPA-S) regimen, 242 (1.53%) on SRL-MPA-S, 300 (1.90%) on SRL-TAC-S, and 217 (1.38%) on SRL-CSA-S. Compared with the standard regimen, the adjusted risks of all-cause death and overall graft loss over a maximum 5-year follow-up were highest with SRL-MPA-S, intermediate with SRL-TAC-S and not significantly different with SRL-CSA-S. The adjusted risks of all-cause death and o...Continue Reading

References

Jan 25, 2003·BMJ : British Medical Journal·Douglas G Altman, J Martin Bland
Oct 8, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Panduranga S Rao, Akinlolu Ojo
Apr 23, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Jagbir GillSuphamai Bunnapradist
Sep 29, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Céline MaréchalMichel Jadoul
Nov 8, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·F CortazarM Wolf
Sep 6, 2012·Chest·Anthony J Langone, J Harold Helderman
Sep 11, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·M AbecassisK P High
Oct 3, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·T IsakovaM Wolf
Jul 26, 2013·BMC Geriatrics·Niall J DempsterDavid Kingsmore
Sep 24, 2013·Transplantation·Arman FaravardehHassan N Ibrahim
Jan 9, 2014·European Journal of Preventive Cardiology·Sumeet SubherwalEmil L Fosbol
Feb 19, 2014·Atherosclerosis·Wim MartinetGuido R Y De Meyer
Jul 22, 2014·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A B MassieD L Segev
Sep 29, 2015·Transplantation Reviews·L J LehnerK Budde
Oct 1, 2015·Kidney International·Takayuki Hamano
Feb 24, 2016·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·D A AxelrodK L Lentine
Jun 10, 2016·Transplantation Reviews·Nuria MonteroOndrej Viklicky
Jul 8, 2016·Oncotarget·Simon C Johnson, Matt Kaeberlein
Jul 23, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Sunil V BadveDavid W Johnson
Aug 25, 2017·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Cristiane Akemi KojimaLuis Gustavo Modelli de Andrade
Feb 28, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A HartA K Israni

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