scholarly journals Randomized study with cyclosporine in kidney transplantation: 10-year follow-up.

1996 ◽  
Vol 7 (5) ◽  
pp. 792-797
Author(s):  
C Ponticelli ◽  
G Civati ◽  
A Tarantino ◽  
F Quarto di Palo ◽  
G Corbetta ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Graft Survival ◽  
Controlled Trial ◽  
Randomized Study ◽  
Graft Function ◽  
Rank Test ◽  
Cadaveric Renal Transplantation ◽  
Azathioprine Group

This study presents the 10-yr follow-up results of a multicenter controlled trial on 108 recipients of cadaveric renal transplantation, randomized to receive cyclosporine (N = 55) or azathioprine (N = 53), both in combination with steroids. The 10-yr patient survival rate was 89% in the cyclosporine group and 83% in the azathioprine group (P = not significant [NS]); the 10-yr graft survival was 56% and 35%, respectively (log-rank test, P = 0.009). The half-life of grafts functioning after 1 yr was 15.4 +/- 3.9 versus 10.6 +/- 3.6, P = NS). The rate of early rejection in the cyclosporine group was significantly lower than that in the azathioprine group (0.30 versus 1.4, P < 0.01). Although the mean creatinine clearance rate was always higher in the azathioprine group, the decline in graft function from the first to the tenth yr was not significantly different between the two groups (-13.0 +/- 16.4 versus -12.3 +/- 19 mL/min, P = NS). In cadaveric renal transplantation, cyclosporine allows better graft survival than azathioprine, not only in the short term but also in the long term, with similar attrition of graft function for up to 10 yr.

scholarly journals Long-Term Results of a Randomized Study Comparing Three Immunosuppressive Schedules with Cyclosporine in Cadaveric Kidney Transplantation

2001 ◽  
Vol 12 (10) ◽  
pp. 2163-2169 ◽  
Author(s):  
GIUSEPPE MONTAGNINO ◽  
ANTONIO TARANTINO ◽  
GIUSEPPE P. SEGOLONI ◽  
VINCENZO CAMBI ◽  
GAETANO RIZZO ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Graft Survival ◽  
Controlled Trial ◽  
Randomized Study ◽  
Dual Therapy ◽  
The Other ◽  
Long Term Results ◽  
Cadaveric Kidney

Abstract. In this randomized controlled trial started in October 1990, 354 cadaveric kidney transplant recipients were assigned to receive either cyclosporine (CsA) monotherapy (115 patients), CsA + steroids (117 patients), or CsA + steroids + azathioprine (122 patients). The median follow-up was 85.1 mo. Thirty-one deaths occurred (infection, 12; cardiovascular disease, 11; neoplasia, 4; and others, 4), and 65 grafts were lost, mostly due to acute (15) or chronic rejection (50). The cumulative graft half-life was 18.1 yr. According to the “intention-to-treat,” the 9-yr actuarial patient and graft survival were 94.0% and 73.3%, respectively, in monotherapy, 87.3% and 65.9% in dual therapy, and 87% and 72.2% in triple therapy (P= 0.647). At the last follow-up, the percentage of patients who remained with the original treatment was 51.2% in monotherapy, 81.7% in dual therapy, and 63.3% in triple therapy. At the seventh year, the mean creatinine clearances were 54.9 ± 17.6 ml/min in monotherapy, 57.9 ± 23.4 in dual therapy, and 60.6 ± 20.7 in triple therapy (P= 0.375). Cataracts (P= 0.000), osteoporosis (P= 0.000), and cardiovascular complications (P= 0.000) were more frequent in dual or triple therapy than in monotherapy. Actuarial graft survival at 9 yr in patients on monotherapy who had to have steroids added was similar to that of the other two groups (62.2%versus69.3%,P= 0.134). In conclusion, actuarial patient and graft survivals did not differ among the three schemes. The long-term renal function and survival were not affected in the patients on monotherapy who needed the addition of steroids. Monotherapy was associated with a lower incidence of extrarenal complications than the other two regimens.

scholarly journals Expression of MICA in Zero Hour Biopsies Predicts Graft Survival After Liver Transplantation

2021 ◽  
Vol 12 ◽  
Author(s):  
Thomas Resch ◽  
Hubert Hackl ◽  
Hannah Esser ◽  
Julia Günther ◽  
Hubert Schwelberger ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Function ◽  
Graft Survival ◽  
Predictive Value ◽  
Risk Index ◽  
Graft Function ◽  
Inverse Correlation ◽  
Rank Test ◽  
Short And Long Term

In search for novel biomarkers to assess graft quality, we investigated whether defined candidate genes are predictive for outcome after liver transplantation (LT).Zero-hour liver biopsies were obtained from 88 livers. Gene expression of selected candidate markers was analyzed and correlated with clinical parameters as well as short and long-term outcomes post LT. Whereas both, the calculated Eurotransplant Donor-Risk-Index and the donor body mass index, had either a poor or no predictive value concerning serum levels indicative for liver function (ALT, AST, GGT, bilirubin) after 6 months, chronological donor age was weakly predictive for serum bilirubin (AUC=0.67). In contrast, the major histcompatibility complex class I related chain A (MICA) mRNA expression demonstrated a high predictive value for serum liver function parameters revealing an inverse correlation (e.g. for ALT: 3 months p=0.0332; 6 months p=0.007, 12 months 0.0256, 24 months p=0.0098, 36 months, p=0.0153) and proved significant also in a multivariate regression model. Importantly, high expression of MICA mRNA revealed to be associated with prolonged graft survival (p=0.024; log rank test) after 10 years of observation, whereas low expression was associated with the occurrence of death in patients with transplant related mortality (p=0.031). Given the observed correlation with short and long-term graft function, we suggest MICA as a biomarker for pre-transplant graft evaluation.

scholarly journals Cadaveric renal transplantation against a positive crossmatch under tacrolimus immunosuppression: Long-term follow-up

1997 ◽  
Vol 29 (1-2) ◽  
pp. 312 ◽  
Author(s):  
J.C. Lyne ◽  
C.A. Vivas ◽  
R. Shapiro ◽  
V.P. Scantlebury ◽  
T.R. Hakala ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Cadaveric Renal Transplantation ◽  
Long Term Follow Up ◽  
Positive Crossmatch

Short-term and long-term effects of slow graft function on graft survival in pediatric live donor renal transplantation

2009 ◽  
Vol 14 (2) ◽  
pp. 196-202 ◽  
Author(s):  
Hasan Otukesh ◽  
Rozita Hosein ◽  
Seyed-Mohammad Fereshtehnejad ◽  
Azam Riahifard ◽  
Abbas Basiri ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Graft Survival ◽  
Graft Function ◽  
Live Donor ◽  
Long Term Effects ◽  
Short Term

Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: Median 3-year follow-up.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 284-284 ◽  
Author(s):  
Angela Smith ◽  
Jeffrey W. Nix ◽  
Matthew Edward Nielsen ◽  
Eric Wallen ◽  
Raj Pruthi
Keyword(s):  
Bladder Cancer ◽  
Controlled Trial ◽  
Randomized Study ◽  
Cancer Recurrence ◽  
Open Group ◽  
Robotic Group ◽  
Recurrence Rates ◽  
Robotic Cystectomy

284 Background: We reported our results on a prospective, randomized trial of open vs. robotic cystectomy in 2008. Three years later, we report our findings with regard to overall (OS) and disease-specific survival (DS), recurrence rates and long-term complications. Methods: A prospective, randomized study comparing open vs. robotic cystectomy for bladder cancer was initiated at our institution with IRB approval in 2008. A target accrual of 40 patients was established to evaluate for non-inferiority based upon nodal yield. Peri-operative and pathologic results were reported in 2008. We now report our median 36-month follow-up for this patient cohort. Results: Of the 41 patients, 21 were randomized to robotic and 20 to open. On surgical pathology, in the robotic group 14 patients had <= pT2, 3 pT3/T4, and 4 N+ disease. In the open group, 9 had <= pT2, 5 pT3/T4, and 7 N+ disease. No positive margins were noted. With median follow-up of 35 and 36 months in the robotic and open arms, OS was 65% (13/20) and 81% (17/21) respectively (p=0.3058). DSS was 68% in the open group (13/19) and 85% in the robotic group (17/20) (p=0.2733). There were 7 recurrences (35%) in the open cohort compared to 3 patients (14%) undergoing the robotic procedure (p=0.1589). Examining overall complications, there were no differences between the open and robotic groups when evaluating 30-day complications and >=90 day complications (p=0.8651). The open and robotic cohorts demonstrated 2 strictures in each cohort. Two parastomal hernias were noted in the open group compared to none in the robotic group. On multivariate analysis, controlling for age, BMI and pathologic stage, cystectomy type did not predict OS or DSS, recurrences, or complications. Conclusions: Median 3-year follow-up evaluating open versus robotic cystectomy demonstrates no differences with regard to OS, DSS, cancer recurrence or long-term complications. Although this study was not powered to assess survival differences, this is the first randomized study to report such data in a non-selected population with 3-year median follow-up.

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