Document Detail


Incidence, therapy, and consequences of lymphocele after sirolimus-cyclosporine-prednisone immunosuppression in renal transplant recipients.
MedLine Citation:
PMID:  12364859     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Robert M Langer; Barry D Kahan
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Transplantation     Volume:  74     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-10-04     Completed Date:  2002-10-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  804-8     Citation Subset:  IM    
Affiliation:
The University of Texas Medical School at Houston, Department of Surgery, Division of Immunology and Organ Transplantation, Houston, TX 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
38016-15//PHS HHS
Chemical
Reg. No./Substance:
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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