Impact of @entity618 on recurrent rejection in kidney transplant XXXX .

@entity1 @entity1667 @entity137 @entity500 @entity229 @entity205 @entity2098 @entity618 @entity1431 @entity288
PURPOSE: @entity618 ( @entity2098 ) has emerged as a valuable adjunctive agent in renal transplantation. However, due to intolerable adverse effects associated with @entity2098 use in our transplant population, we have used @entity2098 selectively in @entity1 at high risk for recurrent graft rejection, since these @entity1 are known to be at risk for poor long-term graft outcomes. The purpose of this study was to assess the efficacy of @entity2098 in preventing the recurrence of acute rejection following an initial rejection episode in kidney transplant @entity1 in the first year following transplantation. METHODS: Forty-four kidney transplant recipients were given @entity2098 prospectively following treatment of their initial rejection episode to prevent recurrent rejection. @entity2098 1-2 g/d was given. Doses were adjusted based on tolerance; @entity2098 therapy was to be continued for at least 6 months. The control group consisted of 124 consecutive kidney transplant recipients who had received standard anti-rejection therapy without the addition of @entity2098 . Maintenance immunosuppression consisted predominantly of @entity205 , @entity229 +/- @entity500 . Anti-rejection therapy for both groups consisted of either @entity288 ( @entity1667 500 mg i.v. for 3 d or oral @entity229 2 mg/kg/d with rapid taper over 3 wk), OKT3 5 mg/d for 10 d or ATG 15 mg/kg/d for 10 d. All rejection episodes were confirmed by biopsy. RESULTS: The majority of rejection episodes were characterized histologically as mild or moderate. Most @entity1 (76%) received corticosteroids for treatment of their first rejection episode. There was a 68% reduction in the incidence of recurrent rejection episodes within the first year of transplant in @entity1 receiving @entity2098 ; only 14% of recipients receiving @entity2098 developed recurrent rejection compared to 44% of @entity1 in the control group (p<0.05). Approximately 50% of @entity1 developed @entity2098 -associated adverse effects ( @entity1431 , @entity137 ). Only 52% of @entity1 remained on @entity2098 at 6 months. One-yr graft survival was 86% in the @entity2098 group and 89% in the control group (p>0.05). One-year @entity1 survival was 93 and 100%, respectively (p>0.05). CONCLUSIONS: The addition of @entity2098 to maintenance therapy for @entity1 experiencing acute renal allograft rejection may prevent recurrent rejection episodes in the subsequent follow-up year.
