| Incidence, therapy, and consequences of lymphocele after sirolimus-cyclosporine-prednisone immunosuppression in renal transplant recipients. | |
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MedLine Citation:
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PMID: 12364859 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In a retrospective study we sought to dissect the factors associated with an increased occurrence of clinically significant perinephric fluid collections and lymphoceles among sirolimus-treated renal transplant recipients. METHODS: We compared the incidence, predisposing factors, and consequences of these fluid collections among patients treated with sirolimus-cyclosporine (CsA)-prednisone (Pred) (n=354, group I) versus CsA-Pred with or without azathioprine (n=136, group II). RESULTS: More group I patients (135/354; 38.1%) displayed perinephric fluid collections (denoted as group III) then group II patients (24/136; 17.6%) (denoted as group IV) (P <0.001). In both subgroups the serum creatinine levels were elevated at the time of diagnosis from a nadir of 2.04+/-1.61 to 4.09+/-2.95 mg/dL (group III) and from 2.53+/-2.34 to 4.36+/-2.90 mg/dL (group IV). A significantly greater number of patients required treatment for lymphoceles among group I (56/354; 15.8%) versus group II recipients (6/136; 4.4%; P<0.001). Single or repeated percutaneous drainage procedures successfully treated 35 group I patients versus all 6 group IV patients (P =0.033). No patients in group II versus 21 patients in group I underwent surgical procedures (P <0.001). A significantly higher rate and higher histologic grade of acute rejection episodes, particularly proximate to the onset of the lymphocele, occurred among group IV patients, namely 54.2% (13/24) versus 21.4% (29/135) group III patients (P <0.001). CONCLUSIONS: Addition of sirolimus to a CsA-Pred regimen resulted in both a higher incidence and a requirement for more aggressive treatment of perinephric fluid collections and lymphoceles. |
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Authors:
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Robert M Langer; Barry D Kahan |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Transplantation Volume: 74 ISSN: 0041-1337 ISO Abbreviation: Transplantation Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-10-04 Completed Date: 2002-10-18 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: United States |
Other Details:
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Languages: eng Pagination: 804-8 Citation Subset: IM |
Affiliation:
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The University of Texas Medical School at Houston, Department of Surgery, Division of Immunology and Organ Transplantation, Houston, TX 77030, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cyclosporine / administration & dosage Drug Therapy, Combination Female Graft Rejection Humans Immunosuppression Immunosuppressive Agents / administration & dosage* Incidence Kidney Transplantation / adverse effects* Lymphocele / epidemiology*, therapy Male Middle Aged Prednisone / administration & dosage Retrospective Studies Sirolimus / administration & dosage |
| Grant Support | |
ID/Acronym/Agency:
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38016-15//PHS HHS |
| Chemical | |
Reg. No./Substance:
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0/Immunosuppressive Agents; 53-03-2/Prednisone; 53123-88-9/Sirolimus; 59865-13-3/Cyclosporine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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