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- Title
Tacrolimus and mycophenolate regimen and subclinical tubulo-interstitial inflammation in low immunological risk renal transplants.
- Authors
Torres, Irina B.; Reisæter, Anna V.; Moreso, Francesc; Âsberg, Anders; Vidal, Marta; Garcia-Carro, Clara; Midtvedt, Karsten; Reinholt, Finn P.; Scott, Helge; Castellà, Eva; Salcedo, Maite; Dörje, Christina; Sellarés, Joana; Azancot, Maria A.; Perello, Manel; Holdaas, Hallvard; Serón, Daniel
- Abstract
The aim was to evaluate the relationship between maintenance immunosuppression, subclinical tubulo-interstitial inflammation and interstitial fibrosis/tubular atrophy ( IF/ TA) in surveillance biopsies performed in low immunological risk renal transplants at two transplant centers. The Barcelona cohort consisted of 109 early and 66 late biopsies in patients receiving high tacrolimus ( TAC-C0 target at 1-year 6-10 ng/ml) and reduced MMF dose (500 mg bid at 1-year). The Oslo cohort consisted of 262 early and 237 late biopsies performed in patients treated with low TAC-C0 (target 3-7 ng/ml) and standard MMF dose (750 mg bid). Subclinical inflammation, adjusted for confounders, was associated with low TAC-C0 in the early ( OR: 0.75, 95% CI: 0.61-0.92; P = 0.006) and late biopsies ( OR: 0.69, 95% CI: 0.50-0.95; P = 0.023) from Barcelona. In the Oslo cohort, it was associated with low MMF in early biopsies ( OR: 0.90, 95% CI: 0.83-0.98; P = 0.0101) and with low TAC-C0 in late biopsies ( OR: 0.77, 95% CI: 0.61-0.97; P = 0.0286). MMF dose was significantly reduced in Oslo between early and late biopsies. IF/ TA was not associated with TAC-C0 or MMF dose in the multivariate analysis. Our data suggest that in TAC- and MMF-based regimens, TAC-C0 levels are associated with subclinical inflammation in patients receiving reduced MMF dose.
- Subjects
TACROLIMUS; MYCOPHENOLIC acid; KIDNEY disease risk factors; KIDNEY transplant complications; INFLAMMATION; RENAL biopsy; IMMUNOSUPPRESSION; FIBROSIS; THERAPEUTICS
- Publication
Transplant International, 2017, Vol 30, Issue 11, p1119
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.13002