Advagraf de Novo. Use Comparative of Advagraf Compared with Prograf

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Abstract

Introduction

The factor of adhesion is key in the evolution of renal transplant to medium and long term…compare the safety and effectiveness in the use of novo advagraf vs prograf.

Material and Method

Evaluated in form prospective 107 patients adults that received 1 ER or 2 do transplant renal donor cadaveric or of donor alive, between the years 2009 and 2010. Follow up 6 years.

Material and Method

Inmunosuppression prograf or advagraf, cell cept or myfortic or rapamune or certican and steroids. Received induction the 37% of the patients, 25% with polyclonal and 12% with basiliximab. Adults between 18 and 84 years (mean 53 years). Split the patients in two groups, according to receive advagraf (group 1) and prograf group 2 end points acute rejection, patient and kidney survival, nodat, arterial hypertension, renal function, infections, cancer.

Results discussion

Acute reject group 1 year: 1 11.53% year 6 15.3%. Group 2 year 1 12.7% year 6 16.6%

Results discussion

Patient survival group 1 year 1 (96.1% p s) year 6 (90% p s) group 2 year 1 ps (94,54%) year 6 ps (90,38%).

Results discussion

Graft survival group 1 year 1 94,23% including death as a cause of lost 90,38% year: 6 82.6%. (and with death skewed 86.7%) group 2 year 1 90.9% and skewed the death: 96,15% year 6 80%, and with bias's death: 89%

Results discussion

Nodat group 1 year 1 5, 76%, year 6 11.53 % group 2 year 1 7.27% year 6 12.72%

Results discussion

Arterial hypertension group 1 year 1 55.7% (40% received 1 drug, 33% 2 drugs and 27% 3 drugs.) Year: 6 48.07% (51% 1 drug, 29% 2 drugs and 20% 3 drugs). Group 2 year 1 58.1% (38% 1 drug, 36% 2 drugs, 26% 3 drugs) year 6 54.5%. (43% 1 drug, 35% 2 drugs, 22% 3 drugs).

Results discussion

Renal function Clearence creatinine (mdrd) group 1 year 1 71 ml min year 6 52 ml min group 2 year 1 69 ml min year 6 48 ml min

Results discussion

Severe infections: Group 1 year 1 30,7% 2 p. sepsis respiratory bacterial. 3 p. Infection urinary tract, 4 p. Pneumonia acute, 1 p. Diverticulitis, 1 p histoplasmosis lung, 2 p. Cmv digestive. Year 6 48,07% 6 p. Pneumonia bacterial, 8 p. Infection urinary tract., 1 p cholangitis acute, 1 p. Diverticulitis.1 p. Cryptococcosis brain, 1 p nefrop by bk, 2 p cmv digestive.6 p. Herpes zoster. Group 2 year 1 43%. 1 p abdominal sepsis, 1 p respiratory sepsis, 7 p urinary infection 5 p pneumonia, 1 p. Appendicitis acute, 1 p criptococoisi brain, 3 p. Cmv digestive, 4 zoster. Year 6 52,7% 6 p. Pneumonia, 10 p. Urinary infections, 1 p. Mucormycosis, 1 p lung histoplasmosis, 2 p. Nocardia pulmonary and skin, 6 p zoster, 2 p. Cmv digestive

Results discussion

Neoplasms: Group 1 year 1 0% year 6 3.87%. 1 basal skincell, 1 carcinoma colon group 2 year 1 0% year 6 5.45%, 1 basal cell, 1 native kidney, 1 cervical.uterus

Results discussion

Deaths: Group 1 13.4%, group 2 14.5%

Conclusions

We can conclude, that in the population studied, low-risk immune, the use of advagraf de novo is safe and effective, and should rest in usual indication.

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