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
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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Article
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Status: |
Published |
Creators/Authors: |
Creators | Email | Pitt Username | ORCID ![](/images/orcid_id_24x24.png) |
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Basu, A | | | | Falcone, JL | | | | Tan, HP | | | | Hassan, D | | | | Dvorchik, I | | | | Bahri, K | | | | Thai, N | | | | Randhawa, PS | | | | Marcos, A | | | | Starzl, TE | tes11@pitt.edu | TES11 | | Shapiro, R | | | |
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Centers: |
Other Centers, Institutes, Offices, 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: |
04 Feb 2019 16:55 |
URI: |
http://d-scholarship.pitt.edu/id/eprint/5627 |
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