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https://hdl.handle.net/2440/73404
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Type: | Journal article |
Title: | Mycophenolate versus azathioprine for kidney transplantation: a 15-year follow-up of a randomized trial |
Author: | Clayton, P. McDonald, S. Chapman, J. Chadban, S. |
Citation: | Transplantation, 2012; 94(2):152-158 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2012 |
ISSN: | 0041-1337 1534-6080 |
Statement of Responsibility: | Philip A. Clayton, Stephen P. McDonald, Jeremy Chapman and Steven J. Chadban |
Abstract: | BACKGROUND: The use of mycophenolate mofetil (MMF) is associated with less acute rejection than azathioprine (AZA) early after kidney transplantation. However, the long-term impact of MMF versus AZA is less well studied. METHODS: The Tricontinental Mycophenolate Mofetil Renal Transplantation Study was a double-blind randomized placebo-controlled trial of MMF versus AZA, together with cyclosporine and steroids, first reported in 1996. We analyzed the long-term outcomes of the Australian cohort of patients enrolled in this study using follow-up data from the Australia and New Zealand Dialysis and Transplant Registry. Patient and graft survival, cancer incidence, and estimated kidney function were compared on an intention-to-treat basis. RESULTS: A total of 133 Australian patients participated in the study: 45 were randomized to AZA, 44 were randomized to MMF 2 g/d, and 44 were randomized to MMF 3 g/d. Baseline characteristics were similar between the groups. Median follow-up was 13.8 years, during which there were 97 graft failures, 75 deaths, and 1 lost to follow-up. There were no statistically significant differences between the groups in long-term patient or graft survival, cancer incidence, or kidney function. Death-censored graft survival was best in the group with 3 g/d MMF and worst in the group with 2 g/d MMF. By 5 years, 42% of the MMF group had switched permanently to AZA, whereas crossover from AZA to MMF was rare. CONCLUSIONS: This long-term examination, although limited by small numbers, found little evidence for the superiority of MMF over AZA. |
Keywords: | Humans Mycophenolic Acid Creatinine Azathioprine Immunosuppressive Agents Glomerular Filtration Rate Kidney Transplantation Follow-Up Studies Double-Blind Method Adult Middle Aged Female Male |
Rights: | (C) 2012 Lippincott Williams & Wilkins, Inc. |
DOI: | 10.1097/TP.0b013e31825475a3 |
Published version: | http://dx.doi.org/10.1097/tp.0b013e31825475a3 |
Appears in Collections: | Aurora harvest 5 Public Health publications |
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