(
11 Meier-Kriesche HU, Steffen BJ, Chu AH, Loveland JJ, Gordon RD, Morris JA, et al. Sirolimus with neoral versus mycophenolate mofetil with neoral is associated with decreased renal allograft survival. Am J Transplant 2004;4:2058-66. DOI: http://dx.doi.org/10.1111/j.1600-6143.2004.00624.x
http://dx.doi.org/10.1111/j.1600-6143.20...
)
|
SRTR Registry |
1998 to 2013 4 years |
21,017 |
1999 |
- |
De novo
|
CsA/SRL: lower use of indication in the group |
79.3% CsA/ MMF 74.6 CsA/ SRL (HR = 1.22) |
ns. |
(
22 Meier-Kriesche HU, Schold JD, Srinivas TR, Howard RJ, Fujita S, Kaplan B. Sirolimus in combination with tacrolimus is associated with worse renal allograft survival compared to mycophenolate mofetil combined with tacrolimus. Am J Transplant 2005;5:2273-80. DOI: http://dx.doi.org/10.1111/j.1600-6143.2005.01019.x
http://dx.doi.org/10.1111/j.1600-6143.20...
)
|
SRTR Registry |
2000 to 2004 3 years |
44,915 |
5393 |
- |
de novo
|
|
85.9% TAC/ MMF 85.3% CsA/ MMF (HR = 1.15) 82.2% CsA/ SRL (HR = 1.38) 80.3% TAC/ SRL (HR = 1.47) |
92.2% TAC/ MMF 91.0% CsA/ MMF (HR = 1.22) 90.0% CsA/ SRL (HR = 1.49) 89.9% TAC/ SRL (HR = 1.41) |
(
33 Srinivas TR, Schold JD, Guerra G, Eagan A, Bucci CM, Meier-Kriesche HU. Mycophenolate mofetil/sirolimus compared to other common immunosuppressive regimens in kidney transplantation. Am J Transplant 2007;7:586-94. DOI: http://dx.doi.org/10.1111/j.1600-6143.2006.01658.x
http://dx.doi.org/10.1111/j.1600-6143.20...
)
|
SRTR Registry |
2000 to 2005 5 years |
49,412 |
6394 (73%) |
2325 (27%) |
de novo
|
SRL/MMF: higher donor age, higher rate of deceased donor |
73.8% TAC/ MMF 71.8% CSA/ MMF (HR = 1.16) 68.9% TAC/ SRL (HR = 1.38) 67.6% CSA/ SRL (HR = 1.37) 57.7% SRL/ MMF (HR = 2.01) |
TAC/MMF CSA/MMF (HR = 1.17) TAC/SRL (HR = 1.33) CSA/SRL (HR = 1.49) SRL/MMF (HR = 1.75) |
(
44 Cortazar F, Molnar MZ, Isakova T, Czira ME, Kovesdy CP, Roth D, et al. Clinical outcomes in kidney transplant recipients receiving long-term therapy with inhibitors of the mammalian target of rapamycin. Am J Transplant 2012;12:379-87. DOI: http://dx.doi.org/10.1111/j.1600-6143.2011.03826.x
http://dx.doi.org/10.1111/j.1600-6143.20...
)
|
Hungary cohort |
2007 3 years |
1241 |
37 (37%) |
64 (63%) |
conversio |
Higher number with neoplasia and diabetes |
ns. |
ns. Patients with a history of neoplasia (HR = 2.6- 5.6) |
(
55 Isakova T, Xie H, Messinger S, Cortazar F, Scialla JJ, Guerra G, et al. Inhibitors of mTOR and risks of allograft failure and mortality in kidney transplantation. Am J Transplant 2013;13:100-10. DOI: http://dx.doi.org/10.1111/j.1600-6143.2012.04281.x
http://dx.doi.org/10.1111/j.1600-6143.20...
)
|
UNOS Registry |
1999 to 2010 2-8 years |
125,623 |
10,510 (76.4%) |
3,237 (23.5%) |
de novo
|
imTOR without iCN: higher number with a history of malignancy, diabetes and kidney from expanded-criterion donor; higher PRA and TIF |
iCN/imTOR (HR = 1.07) imTOR/ MMF (HR = 1.17) |
iCN/imTOR (HR = 1.13) imTOR/ MMF (HR = 1.25) |
(
66 Knoll GA, Kokolo MB, Mallick R, Beck A, Buenaventura CD, Ducharme R, et al. Effect of sirolimus on malignancy and survival after kidney transplantation: systematic review and meta-analysis of individual patient data. BMJ 2014;349:g6679. PMID: 25422259 DOI: http://dx.doi.org/10.1136/bmj.g6679
http://dx.doi.org/10.1136/bmj.g6679...
)
|
Systematic review |
1999 to 2013 1 year to 4 years |
2,600 |
|
|
de novo 4,717 (80.3%) conversion 1,159 (19.7%) |
unreported |
Not analyzed |
imTOR (HR = 1.43) |
(
77 Badve SV, Pascoe EM, Burke M, Clayton PA, Campbell SB, Hawley CM, et al. Mammalian Target of Rapamycin Inhibitors and Clinical Outcomes in Adult Kidney Transplant Recipients. Clin J Am Soc Nephrol 2016 Jul 21. [Epub ahead of print] DOI: http://dx.doi.org/10.2215/CJN.00190116
http://dx.doi.org/10.2215/CJN.00190116...
)
|
Australia and New Zealand Registry |
1996 to 2012 7 years |
7,801 |
398 (25.5%) |
1,162 (74.5%) |
de novo 481 early conversion 504 late conversion 567 |
Higher number of Caucasians and history of neoplasia. Lower number of patients with a history of diabetes and cardiovascular disease |
ns. |
imTOR (HR = 1.47) |
(
88 Santos AH, Casey MJ, Wen X, Womer KL. Association of Baseline Viral Serology and Sirolimus Regimens with Kidney Transplant Outcomes: A Fourteen Year Registry-Based Cohort Study in the US. Transplantation 2017;101:377-86. DOI: http://dx.doi.org/10.1097/TP.0000000000001520
http://dx.doi.org/10.1097/TP.00000000000...
)
|
SRTR Registry |
2000 to 2013 5 years |
56,764 |
2,167 (44.9%) |
2,659 (55.1%) |
de novo
|
African- American recipient; expanded criterion donor with coronary disease |
TAC/MMF TAC/SRL (HR = 1.38) SRL/MMF (HR = 1.41) |
TAC/MMF TAC/SRL (HR = 1.59) SRL/MMF (HR = 1.44) |