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Interstitial Fibrosis Quantification in Renal Transplant Recipients Randomized to Continue Cyclosporine or Convert to Sirolimus
Author(s) -
Servais A.,
MeasYedid V.,
Toupance O.,
Lebranchu Y.,
Thierry A.,
Moulin B.,
Etienne I.,
Presne C.,
Hurault De Ligny B.,
Le Pogamp P.,
Le Meur Y.,
Glotz D.,
Hayem C.,
Marin J. C. Olivo,
Thervet E.
Publication year - 2009
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2009.02803.x
Subject(s) - medicine , sirolimus , urology , transplantation , renal function , kidney disease , kidney transplantation , kidney , hazard ratio , biopsy , randomized controlled trial , fibrosis , gastroenterology , confidence interval
Conversion from cyclosporine (CsA) to sirolimus at week 12 after kidney transplantation is associated with a significant improvement in renal function. The aim of this analysis was to investigate the effect of this conversion on interstitial fibrosis (IF), a hallmark of chronic allograft injury, in patients taking part in the CONCEPT trial. This multicenter, prospective, trial included 193 renal recipients randomized at week 12 to switch from CsA to sirolimus or to continue CsA, with mycophenolate mofetil. Routine biopsy with automated, quantified assessment of IF by a program of color segmentation was performed at 1 year in 121 patients. At 1 year, renal function was significantly improved in the conversion group as assessed by estimated GFR (MDRD) and measured GFR. Biopsy results, however, showed no between‐group difference in percentage of IF. Calculated GFR at 1 year was significantly associated with the percentage of IF (p = 0.004, R 2 = 0.07). By multivariate analysis diabetic patients had more fibrosis than non‐diabetic patients. In conclusion, although kidney transplant patients converted from CsA to sirolimus showed significant improvement in renal function, we found no difference of IF on 1‐year biopsies.