Article

Calcineurin Inhibitor Minimization in the Symphony Study: Observational Results 3 Years after Transplantation

Lund University, Malmö, Sweden.
American Journal of Transplantation (Impact Factor: 6.19). 07/2009; 9(8):1876-85. DOI: 10.1111/j.1600-6143.2009.02726.x
Source: PubMed

ABSTRACT The Symphony study showed that at 1 year posttransplant, a regimen based on daclizumab induction, 2 g mycophenolate mofetil (MMF), low-dose tacrolimus and steroids resulted in better renal function and lower acute rejection and graft loss rates compared with three other regimens: two with low-doses of cyclosporine or sirolimus instead of tacrolimus and one with no induction and standard cyclosporine dosage. This is an observational follow-up for 2 additional years with the same endpoints as the core study. Overall, 958 patients participated in the follow-up. During the study, many patients changed their immunosuppressive regimen (e.g. switched from sirolimus to tacrolimus), but the vast majority (95%) remained on MMF. During the follow-up, renal function remained stable (mean change: -0.6 ml/min), and rates of death, graft loss and acute rejection were low (all about 1% per year). The MMF and low-dose tacrolimus arm continued to have the highest GFR (68.6 +/- 23.8 ml/min vs. 65.9 +/- 26.2 ml/min in the standard-dose cyclosporine, 64.0 +/- 23.1 ml/min in the low-dose cyclosporine and 65.3 +/- 26.2 ml/min in the low-dose sirolimus arm), but the difference with the other arms was not significant (p = 0.17 in an overall test and 0.077, 0.039 and 0.11, respectively, in pair-wise tests). The MMF and low-dose tacrolimus arm also had the highest graft survival rate, but with reduced differences between groups over time, and the least acute rejection rate. In the Symphony study, the largest ever prospective study in de novo kidney transplantation, over 3 years, daclizumab induction, MMF, steroids and low-dose tacrolimus proved highly efficacious, without the negative effects on renal function commonly reported for standard CNI regimens.

Download full-text

Full-text

Available from: Corrado Bernasconi, Sep 04, 2014
0 Followers
 · 
200 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Experimental results are given for the perveance at different pressures and RF power using nitrogen and argon ions. The results are taken using a constricted axial RF ion source with an aspect ratio of the radius of the outlet aperture to the extraction gap width equals 0.4. Our data confirm the validity of the current scaling law at RF power equals 50 watt 20 watt in case of nitrogen and argon gases respectively at a pressure of 3 μHg. It is found that by increasing the pressure the beam current will decrease. Therefore, in order to keep the beam current constant, the RF power must be increased. In case of nitrogen, at a perveance of 0.24×10<sup>-8</sup> Amp/V<sup>3/2 </sup> corresponding to a pressure of 0.03×10<sup>-8</sup> Amp/V <sup>3/2</sup> corresponding to a pressure of 25 μHg, it reduces to 1.2°. In case of argon, at a perveance of 0.12×10<sup>-8</sup> Amp/V<sup>3/2</sup> corresponding to a pressure of 3 μHg, the beam divergence is 7.2°, while at a perveance of 0.02×10<sup>-8 </sup> Amp/V<sup>3/2</sup> corresponding to a pressure of 25 μHg, it becomes 3.2
    Radio Science Conference, 1996. NRSC '96., Thirteenth National; 04/1996
  • [Show abstract] [Hide abstract]
    ABSTRACT: A new method of optimizing prototypes for a nearest neighbor classifier is proposed based on a four-layer network architecture. A new error function is defined for updating prototypes. The physical meaning of the updating rule and the relationship between the proposed method and LVQ2 are also presented. The main characteristic of the present method is consistent criteria for updating prototypes and for using the trained prototypes to build a nearest neighbor classifier. Experimental results indicate that the present method is effective compared with LVQ2
    Pattern Recognition, 1996., Proceedings of the 13th International Conference on; 09/1996
  • Source
    Transplantation Proceedings 12/2000; 32(7):1980-1. DOI:10.1016/S0041-1345(00)01520-7 · 0.95 Impact Factor
Show more