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Chronic Allograft Nephropathy Score Before Sirolimus Rescue Predicts Allograft Function in Renal Transplant Patients

Basu, A and Falcone, JL and Tan, HP and Hassan, D and Dvorchik, I and Bahri, K and Thai, N and Randhawa, PS and Marcos, A and Starzl, TE and Shapiro, R (2007) Chronic Allograft Nephropathy Score Before Sirolimus Rescue Predicts Allograft Function in Renal Transplant Patients. Transplantation Proceedings, 39 (1). 94 - 98. ISSN 0041-1345

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Abstract

Chronic allograft nephropathy (CAN) is a major indication for initiation of sirolimus (SRL) in renal transplantation (TX) to prevent deterioration of renal function. We evaluated whether the CAN score at time of sirolimus rescue (SRL-R) predicts renal allograft function. CAN score is the sum of the following 4 categories: glomerulopathy (cg, 0-3), interstitial fibrosis (ci, 0-3), tubular atrophy (ct, 0-3), and vasculopathy (cv, 0-3). This is a retrospective cohort study of renal transplant recipients from July 2001 to March 2004. Immunosuppression consisted of preconditioning with rabbit anti-thymocyte globulin or alemtuzumab and maintenance with tacrolimus (TAC) monotherapy with spaced weaning, if applicable, SRL-R was achieved by conversion from TAC, or by addition to reduced doses of TAC. Ninety patients received SRL. Thirty-three of these patients met the inclusion criteria of the following: (1) receipt of SRL for > 6 months, and (2) follow-up of ≥6 months. There were 16 patients in the low-CAN (0-4) group and 17 patients in the high-CAN ( > 4) group. Cockcroft-Gault (C-G) glomerular filtration rate (GFR) was calculated at SRL-R and at 1, 3, 6, and 12 months. The ΔGFR was significantly better in the low-CAN group at 1, 3, and 6 months. A trend toward an improved ΔGFR was present at 12 months in the low-CAN group (P = .16). CAN scoring at the time of SRL-R predicts recovery of renal allograft function (as measured using ΔGFR), and should be used in preference to biochemical markers (Cr and C-G GFR), which may not be reliable predictors. © 2007 Elsevier Inc. All rights reserved.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Basu, A
Falcone, JL
Tan, HP
Hassan, D
Dvorchik, I
Bahri, K
Thai, N
Randhawa, PS
Marcos, A
Starzl, TEtes11@pitt.eduTES11
Shapiro, R
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 2007
Date Type: Publication
Journal or Publication Title: Transplantation Proceedings
Volume: 39
Number: 1
Page Range: 94 - 98
DOI or Unique Handle: 10.1016/j.transproceed.2006.10.017
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0041-1345
Other ID: uls-drl:31735062121516, Starzl CV No. 2241
Date Deposited: 08 Apr 2010 17:38
Last Modified: 13 Oct 2017 20:55
URI: http://d-scholarship.pitt.edu/id/eprint/5627

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