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Long-term prolonged-release tacrolimus outcomes in living donor kidney transplantation: The Japan Academic Consortium of Kidney Transplantation study-II.
- Source :
-
International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2023 May; Vol. 30 (5), pp. 483-491. Date of Electronic Publication: 2023 Feb 16. - Publication Year :
- 2023
-
Abstract
- Objectives: To evaluate the 10-year efficacy and safety of a prolonged-release tacrolimus-based combination immunosuppressive regimen on longer-term outcomes in living donor kidney transplantation.<br />Methods: Data from Japanese living donor kidney transplant recipients (n = 410) maintained on continuous prolonged-release tacrolimus-based immunosuppression from 2009-2013 were analyzed with a median follow-up of 9.9 years.<br />Results: A prolonged-release, tacrolimus-based combination regimen provided death-censored graft failure and all-cause death rates at 10 years of 7.0% and 6.8%, respectively. In multivariable analyses, acute and chronic rejection and 'throughout' (new-onset plus preexisting) diabetes mellitus were risk factors for death-censored graft failure. Recipient age ≥ 65 years, throughout diabetes mellitus and malignancy were common risk factors for all-cause death. Throughout diabetes mellitus was the most common risk factor for both death-censored graft failure and all-cause death. Additional analyses showed 10-year cumulative rates of death-censored graft failure were 14.0% and 5.4% for recipients with or without preexisting diabetes mellitus, respectively (log-rank test: p = 0.009). All-cause death rates were 12.7% and 5.4% in the preexisting and non-diabetes mellitus groups, respectively (log-rank test: p = 0.023).<br />Conclusions: In this real-world, retrospective, living donor kidney transplantation study, a prolonged-release tacrolimus-based immunosuppressive combination regimen provided 10-year death-censored graft failure rates of 14.0% and 5.4% in diabetes mellitus and non-diabetes mellitus patients, respectively; Similarly, 10-year all-cause death rates were 12.7% and 5.4% in diabetes mellitus and non-diabetes mellitus patients, respectively. To our knowledge, the data in this study are the first to provide 10-year transplant outcomes in living donor kidney transplant recipients under prolonged-release tacrolimus-based regimen.<br /> (© 2023 The Japanese Urological Association.)
- Subjects :
- Humans
Aged
Tacrolimus adverse effects
Retrospective Studies
Living Donors
Japan epidemiology
Graft Rejection epidemiology
Graft Rejection prevention & control
Immunosuppressive Agents adverse effects
Graft Survival
Kidney Transplantation adverse effects
Diabetes Mellitus epidemiology
Diabetes Mellitus chemically induced
Subjects
Details
- Language :
- English
- ISSN :
- 1442-2042
- Volume :
- 30
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International journal of urology : official journal of the Japanese Urological Association
- Publication Type :
- Academic Journal
- Accession number :
- 36798048
- Full Text :
- https://doi.org/10.1111/iju.15163