Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival

Autores
Gentilini, María Virginia; Perez Illidge, Luis; Pedraza, Néstor; Nemirovsky, Sergio Ivan; Fernandez, María Florencia; Ramisch, Diego; Solar, Héctor; Rumbo, Martín; Rumbo, Carolina; Gondolesi, Gabriel Eduardo
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objectives: Immunosuppressive strategies for intestinal transplant have changed over time. However, specific intestinal transplant-oriented protocols and reports on long-term maintenance regimens are scarce. Our objective was to evaluate the impact of 2 different initial immunosuppressive protocols based on thymoglobulin (group A) and basiliximab (anti-interleukin 2 antibody) (group B) and of changes to maintenance immunosuppression over long-term follow-up in intestinal transplant recipients. Materials and Methods: We performed a retrospective analysis of a prospectively established protocol for intestinal transplant immunosuppression, conducted between May 2006 and December 2020. We analyzed 51 intestinal transplant recipients, with 6 patients excluded because of early death or graft loss. Acute cellular rejection frequency and grade, number of acute cellular rejection episodes, time to the first acute cellular rejection episode, response to treatment, number of patients who progressed to chronic allograft rejection, kidney function, infections, incidence of posttransplant lymphoproliferative disorder and graft-versus-host disease, and patient and graft survival were analyzed. Results: In the study groups, there were 87 acute cellular rejection episodes in 45 patients (33 in group A and 54 in group B). We found degree of acute cellular rejection to be mild in 45 patients, moderate in 18, and severe in 24 (not significant between groups). Our comparison of induction therapy (thymoglobulin [group A] vs interleukin 2 antibody [group B]) did not show any statistical difference during clinical followup. Long-term review showed that all patients were on tacrolimus. Five-year patient and graft survival rates were 62% and 45% for group A and 54% and 46% for group B, respectively (not significant). Conclusions: Long-term patient and graft outcomes reflected the use of an individualized follow-up with adjustments and changes in immunosuppressive medications according to the patient’s clinical course and complications rather than based on the induction immunosuppressive protocol used.
Fil: Gentilini, María Virginia. Universidad Favaloro; Argentina. Fundación Favaloro; Argentina
Fil: Perez Illidge, Luis. Fundación Favaloro; Argentina. Universidad Favaloro; Argentina
Fil: Pedraza, Néstor. Colombiana de Trasplantes; Colombia
Fil: Nemirovsky, Sergio Ivan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina
Fil: Fernandez, María Florencia. Fundación Favaloro; Argentina
Fil: Ramisch, Diego. Fundación Favaloro; Argentina
Fil: Solar, Héctor. Fundación Favaloro; Argentina
Fil: Rumbo, Martín. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; Argentina
Fil: Rumbo, Carolina. Fundación Favaloro; Argentina
Fil: Gondolesi, Gabriel Eduardo. Universidad Favaloro; Argentina. Fundación Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Materia
IMMUNOLOGICAL RISK
IMMUNOSUPPRESSIVE PROTOCOL
INTESTINAL TRANSPLANT
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/214563
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/214563
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft SurvivalGentilini, María VirginiaPerez Illidge, LuisPedraza, NéstorNemirovsky, Sergio IvanFernandez, María FlorenciaRamisch, DiegoSolar, HéctorRumbo, MartínRumbo, CarolinaGondolesi, Gabriel EduardoIMMUNOLOGICAL RISKIMMUNOSUPPRESSIVE PROTOCOLINTESTINAL TRANSPLANThttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Objectives: Immunosuppressive strategies for intestinal transplant have changed over time. However, specific intestinal transplant-oriented protocols and reports on long-term maintenance regimens are scarce. Our objective was to evaluate the impact of 2 different initial immunosuppressive protocols based on thymoglobulin (group A) and basiliximab (anti-interleukin 2 antibody) (group B) and of changes to maintenance immunosuppression over long-term follow-up in intestinal transplant recipients. Materials and Methods: We performed a retrospective analysis of a prospectively established protocol for intestinal transplant immunosuppression, conducted between May 2006 and December 2020. We analyzed 51 intestinal transplant recipients, with 6 patients excluded because of early death or graft loss. Acute cellular rejection frequency and grade, number of acute cellular rejection episodes, time to the first acute cellular rejection episode, response to treatment, number of patients who progressed to chronic allograft rejection, kidney function, infections, incidence of posttransplant lymphoproliferative disorder and graft-versus-host disease, and patient and graft survival were analyzed. Results: In the study groups, there were 87 acute cellular rejection episodes in 45 patients (33 in group A and 54 in group B). We found degree of acute cellular rejection to be mild in 45 patients, moderate in 18, and severe in 24 (not significant between groups). Our comparison of induction therapy (thymoglobulin [group A] vs interleukin 2 antibody [group B]) did not show any statistical difference during clinical followup. Long-term review showed that all patients were on tacrolimus. Five-year patient and graft survival rates were 62% and 45% for group A and 54% and 46% for group B, respectively (not significant). Conclusions: Long-term patient and graft outcomes reflected the use of an individualized follow-up with adjustments and changes in immunosuppressive medications according to the patient’s clinical course and complications rather than based on the induction immunosuppressive protocol used.Fil: Gentilini, María Virginia. Universidad Favaloro; Argentina. Fundación Favaloro; ArgentinaFil: Perez Illidge, Luis. Fundación Favaloro; Argentina. Universidad Favaloro; ArgentinaFil: Pedraza, Néstor. Colombiana de Trasplantes; ColombiaFil: Nemirovsky, Sergio Ivan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Fernandez, María Florencia. Fundación Favaloro; ArgentinaFil: Ramisch, Diego. Fundación Favaloro; ArgentinaFil: Solar, Héctor. Fundación Favaloro; ArgentinaFil: Rumbo, Martín. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; ArgentinaFil: Rumbo, Carolina. Fundación Favaloro; ArgentinaFil: Gondolesi, Gabriel Eduardo. Universidad Favaloro; Argentina. Fundación Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaBaskent Univ2022-12info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/214563Gentilini, María Virginia; Perez Illidge, Luis; Pedraza, Néstor; Nemirovsky, Sergio Ivan; Fernandez, María Florencia; et al.; Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival; Baskent Univ; Experimental And Clinical Transplantation; 20; 12; 12-2022; 1105-11131304-0855CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/http://www.ectrx.org/detail/archive/2022/20/12/0/1105/0info:eu-repo/semantics/altIdentifier/doi/10.6002/ECT.2022.0359info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:10:59Zoai:ri.conicet.gov.ar:11336/214563instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:11:00.116CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
title Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
spellingShingle Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
Gentilini, María Virginia
IMMUNOLOGICAL RISK
IMMUNOSUPPRESSIVE PROTOCOL
INTESTINAL TRANSPLANT
title_short Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
title_full Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
title_fullStr Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
title_full_unstemmed Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
title_sort Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival
dc.creator.none.fl_str_mv Gentilini, María Virginia
Perez Illidge, Luis
Pedraza, Néstor
Nemirovsky, Sergio Ivan
Fernandez, María Florencia
Ramisch, Diego
Solar, Héctor
Rumbo, Martín
Rumbo, Carolina
Gondolesi, Gabriel Eduardo
author Gentilini, María Virginia
author_facet Gentilini, María Virginia
Perez Illidge, Luis
Pedraza, Néstor
Nemirovsky, Sergio Ivan
Fernandez, María Florencia
Ramisch, Diego
Solar, Héctor
Rumbo, Martín
Rumbo, Carolina
Gondolesi, Gabriel Eduardo
author_role author
author2 Perez Illidge, Luis
Pedraza, Néstor
Nemirovsky, Sergio Ivan
Fernandez, María Florencia
Ramisch, Diego
Solar, Héctor
Rumbo, Martín
Rumbo, Carolina
Gondolesi, Gabriel Eduardo
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv IMMUNOLOGICAL RISK
IMMUNOSUPPRESSIVE PROTOCOL
INTESTINAL TRANSPLANT
topic IMMUNOLOGICAL RISK
IMMUNOSUPPRESSIVE PROTOCOL
INTESTINAL TRANSPLANT
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objectives: Immunosuppressive strategies for intestinal transplant have changed over time. However, specific intestinal transplant-oriented protocols and reports on long-term maintenance regimens are scarce. Our objective was to evaluate the impact of 2 different initial immunosuppressive protocols based on thymoglobulin (group A) and basiliximab (anti-interleukin 2 antibody) (group B) and of changes to maintenance immunosuppression over long-term follow-up in intestinal transplant recipients. Materials and Methods: We performed a retrospective analysis of a prospectively established protocol for intestinal transplant immunosuppression, conducted between May 2006 and December 2020. We analyzed 51 intestinal transplant recipients, with 6 patients excluded because of early death or graft loss. Acute cellular rejection frequency and grade, number of acute cellular rejection episodes, time to the first acute cellular rejection episode, response to treatment, number of patients who progressed to chronic allograft rejection, kidney function, infections, incidence of posttransplant lymphoproliferative disorder and graft-versus-host disease, and patient and graft survival were analyzed. Results: In the study groups, there were 87 acute cellular rejection episodes in 45 patients (33 in group A and 54 in group B). We found degree of acute cellular rejection to be mild in 45 patients, moderate in 18, and severe in 24 (not significant between groups). Our comparison of induction therapy (thymoglobulin [group A] vs interleukin 2 antibody [group B]) did not show any statistical difference during clinical followup. Long-term review showed that all patients were on tacrolimus. Five-year patient and graft survival rates were 62% and 45% for group A and 54% and 46% for group B, respectively (not significant). Conclusions: Long-term patient and graft outcomes reflected the use of an individualized follow-up with adjustments and changes in immunosuppressive medications according to the patient’s clinical course and complications rather than based on the induction immunosuppressive protocol used.
Fil: Gentilini, María Virginia. Universidad Favaloro; Argentina. Fundación Favaloro; Argentina
Fil: Perez Illidge, Luis. Fundación Favaloro; Argentina. Universidad Favaloro; Argentina
Fil: Pedraza, Néstor. Colombiana de Trasplantes; Colombia
Fil: Nemirovsky, Sergio Ivan. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina
Fil: Fernandez, María Florencia. Fundación Favaloro; Argentina
Fil: Ramisch, Diego. Fundación Favaloro; Argentina
Fil: Solar, Héctor. Fundación Favaloro; Argentina
Fil: Rumbo, Martín. Facultad de Ciencias Exactas, Universidad Nacional de la Plata; Argentina
Fil: Rumbo, Carolina. Fundación Favaloro; Argentina
Fil: Gondolesi, Gabriel Eduardo. Universidad Favaloro; Argentina. Fundación Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
description Objectives: Immunosuppressive strategies for intestinal transplant have changed over time. However, specific intestinal transplant-oriented protocols and reports on long-term maintenance regimens are scarce. Our objective was to evaluate the impact of 2 different initial immunosuppressive protocols based on thymoglobulin (group A) and basiliximab (anti-interleukin 2 antibody) (group B) and of changes to maintenance immunosuppression over long-term follow-up in intestinal transplant recipients. Materials and Methods: We performed a retrospective analysis of a prospectively established protocol for intestinal transplant immunosuppression, conducted between May 2006 and December 2020. We analyzed 51 intestinal transplant recipients, with 6 patients excluded because of early death or graft loss. Acute cellular rejection frequency and grade, number of acute cellular rejection episodes, time to the first acute cellular rejection episode, response to treatment, number of patients who progressed to chronic allograft rejection, kidney function, infections, incidence of posttransplant lymphoproliferative disorder and graft-versus-host disease, and patient and graft survival were analyzed. Results: In the study groups, there were 87 acute cellular rejection episodes in 45 patients (33 in group A and 54 in group B). We found degree of acute cellular rejection to be mild in 45 patients, moderate in 18, and severe in 24 (not significant between groups). Our comparison of induction therapy (thymoglobulin [group A] vs interleukin 2 antibody [group B]) did not show any statistical difference during clinical followup. Long-term review showed that all patients were on tacrolimus. Five-year patient and graft survival rates were 62% and 45% for group A and 54% and 46% for group B, respectively (not significant). Conclusions: Long-term patient and graft outcomes reflected the use of an individualized follow-up with adjustments and changes in immunosuppressive medications according to the patient’s clinical course and complications rather than based on the induction immunosuppressive protocol used.
publishDate 2022
dc.date.none.fl_str_mv 2022-12
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/214563
Gentilini, María Virginia; Perez Illidge, Luis; Pedraza, Néstor; Nemirovsky, Sergio Ivan; Fernandez, María Florencia; et al.; Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival; Baskent Univ; Experimental And Clinical Transplantation; 20; 12; 12-2022; 1105-1113
1304-0855
CONICET Digital
CONICET
url http://hdl.handle.net/11336/214563
identifier_str_mv Gentilini, María Virginia; Perez Illidge, Luis; Pedraza, Néstor; Nemirovsky, Sergio Ivan; Fernandez, María Florencia; et al.; Induction Versus Maintenance Immunosuppression After Intestinal Transplant: Determining Which Treatment Most Impacts Long-Term Patient And Graft Survival; Baskent Univ; Experimental And Clinical Transplantation; 20; 12; 12-2022; 1105-1113
1304-0855
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://www.ectrx.org/detail/archive/2022/20/12/0/1105/0
info:eu-repo/semantics/altIdentifier/doi/10.6002/ECT.2022.0359
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Baskent Univ
publisher.none.fl_str_mv Baskent Univ
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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