Rosângela Maria Gomes1,2, Augusto Afonso Guerra Júnior1,2, Lívia Lovato Pires de Lemos2,3, Juliana de Oliveira Costa3, Alessandra Maciel Almeida1,2, Juliana Alvares1,2, Charles Simão Filho4, Mariângela Leal Cherchiglia3, Eli Iola Gurgel Andrade3, Brian Godman5,6, Francisco Assis Acurcio1,2. 1. a Post-Graduation Program in Medicines and Pharmaceutical Assistance, Department of Social Pharmacy , College of Pharmacy, Federal University of Minas Gerais , Minas Gerais , Brazil. 2. b SUS Collaborating Centre - Technology Assessment & Excellence in Health, College of Pharmacy , Federal University of Minas Gerais , Minas Gerais , Brazil. 3. c Post-Graduation Program in Public Health, Department of Preventive and Social Medicine, College of Medicine , Federal University of Minas Gerais , Minas Gerais , Brazil. 4. d Department of Surgery , College of Medicine, Federal University of Minas Gerais , Minas Gerais , Brazil. 5. e Strathclyde Institute of Pharmacy and Biomedical Sciences , University of Strathclyde , Glasgow , United Kingdom. 6. f Division of Clinical Pharmacology , Karolinska Institute , Stockholm , Sweden.
Abstract
BACKGROUND: Cyclosporine and tacrolimus are well established immunosuppressants; however little is known about long term survival rates. The project aim was to compare 10-year graft survival and associated factors among kidney transplant patients within the Brazilian Public Health System (SUS) prescribed either immunosuppressant. METHODS: Analyze a national cohort of kidney transplant recipients within SUS. Graft loss defined by death or dialysis for more than three months. Kaplan-Meier method used to estimate cumulative probabilities of survival. Cox proportional hazards model used to evaluate factors associated with progression to graft loss. RESULTS: 13,811 patients were included, 5,887 used cyclosporine and 7,924 tacrolimus. A higher risk of graft loss was associated with tacrolimus, a deceased donor, additional years of age, median period of dialysis greater than 47 months, diagnosis of diabetes as the primary cause of chronic kidney disease and transplantation between 2005 and 2009. CONCLUSIONS: Among other factors, tacrolimus-based regimens were associated with worse graft survival.
BACKGROUND:Cyclosporine and tacrolimus are well established immunosuppressants; however little is known about long term survival rates. The project aim was to compare 10-year graft survival and associated factors among kidney transplant patients within the Brazilian Public Health System (SUS) prescribed either immunosuppressant. METHODS: Analyze a national cohort of kidney transplant recipients within SUS. Graft loss defined by death or dialysis for more than three months. Kaplan-Meier method used to estimate cumulative probabilities of survival. Cox proportional hazards model used to evaluate factors associated with progression to graft loss. RESULTS: 13,811 patients were included, 5,887 used cyclosporine and 7,924 tacrolimus. A higher risk of graft loss was associated with tacrolimus, a deceased donor, additional years of age, median period of dialysis greater than 47 months, diagnosis of diabetes as the primary cause of chronic kidney disease and transplantation between 2005 and 2009. CONCLUSIONS: Among other factors, tacrolimus-based regimens were associated with worse graft survival.
Authors: Rosângela Maria Gomes; Wallace Breno Barbosa; Brian Godman; Juliana de Oliveira Costa; Nélio Gomes Ribeiro Junior; Charles Simão Filho; Mariângela Leal Cherchiglia; Francisco de Assis Acurcio; Augusto Afonso Guerra Júnior Journal: Int J Environ Res Public Health Date: 2020-03-17 Impact factor: 3.390