[Twenty-five years of calcineurin inhibitors use in kidney transplantation at Erasme Hospital].
The results and risk factors within a cohort of 1.380 renal allografts treated with a calcineurin inhibitor from 1983 to 2008 at Erasme Hospital were analyzed. Three groups corresponding to successive periods were compared: A, from 1983 to 1992 (n = 463); B, from 1993 to 2000 (n = 470); C, from 2001 to 2008 (n = 447). Patient's survival was lower during period C than during periods A and B (89 vs 85% at 8 years, P = 0,044), due to the recipients age. In contrast, graft survival raised gradually (64, 76 and 81% at 8 years for periods A, B and C respectively, P < 0,001). Several factors significantly influence graft survival: in decreasing order, they are the recipient's age (reduced risk of rejection with age), immunosuppressive protocol (superiority of mycophenolate mofetyl and induction with antibodies directed to the IL2 receptor), HLA sensitization, number of HLA-B+Dr mismatches between recipient and donor, and gender (opposite effects of recipient's and donor's gender). The permanent evaluation of results using multivariate analyses would allow to promptly adapt selection and therapeutic strategies within each transplantation center.
Vereerstraeten
P
P
Département de Néphrologie, Dialyse et Transplantation, Hôpital Erasme, Bruxelles. dabram@ulb.ac.be
Wissing
M
M
Broeders
N
N
Dung Hoang
A
A
Mikhalski
D
D
Donckier
V
V
Abramowicz
D
D
D000328:Adult; D065095:Calcineurin Inhibitors; D005260:Female; D006085:Graft Survival; D006761:Hospitals; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013997:Time Factors
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents