ArticleLancet (London, England)2003
Tolerogenic immunosuppression for organ transplantation.
Article in Lancet (London, England), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
90 citing papers in PubMed, 3 syntheses or guidelines pooled it, 497 citations in OpenAlex.
- Antibody induction versus placebo, no induction, or another type of antibody induction for liver transplant recipients.The Cochrane database of systematic reviews · 2014Pooled it
- Antibody induction versus corticosteroid induction for liver transplant recipients.The Cochrane database of systematic reviews · 2014Pooled it
- Calcineurin inhibitor minimisation versus continuation of calcineurin inhibitor treatment for liver transplant recipients.The Cochrane database of systematic reviews · 2012Pooled it
- Trial
- A Double-Blind, Double-Dummy, Flexible-Design Randomized Multicenter Trial: Early Safety of Single- Versus Divided-Dose Rabbit Anti-Thymocyte Globulin Induction in Renal Transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2016Trial
- Trial
- A randomized 2×2 factorial trial, part 1: single-dose rabbit antithymocyte globulin induction may improve renal transplantation outcomes.Transplantation · 2015Trial
- Antithymocyte globulin treatment for patients with recent-onset type 1 diabetes: 12-month results of a randomised, placebo-controlled, phase 2 trial.The lancet. Diabetes & endocrinology · 2013Trial
- Early steroid withdrawal in pediatric renal transplant: five years of follow-up.Pediatric nephrology (Berlin, Germany) · 2011Trial
- Alemtuzumab pre-conditioning with tacrolimus monotherapy in pediatric renal transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2007Trial
- Advances in stimuli-responsive hydrogels for liver disease therapy: mechanisms, applications, and translational perspectives.Drug delivery and translational research · 2026Review
- Induction of Clinical Operational Tolerance Through Immunosuppression Minimization: Less Is More?Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Opinion: Gavage Administration of MXene as a Route-Specific Alternative to Intravenous Injection into the Bloodstream of Laboratory Animals for Reducing Systemic Nanotoxicity Risks in Immunosuppression and Post-Transplantation Models with Bile Acid Modification.Advanced healthcare materials · 2026Article
- Belatacept-based immunosuppression in heart transplant recipients: A single center experience.JHLT open · 2025Article
- Update on Maintenance Immunosuppression in Intestinal Transplantation.Gastroenterology clinics of North America · 2024Review
- Review
- Strategies for Liver Transplantation Tolerance.International journal of molecular sciences · 2021Review
- Operational tolerance in intestinal transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Review
- Drug-Induced Hematological Cytopenia in Kidney Transplantation and the Challenges It Poses for Kidney Transplant Physicians.Journal of transplantation · 2018Review
30 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
22 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundInsight into the mechanisms of organ engraftment and acquired tolerance has made it possible to facilitate these mechanisms, by tailoring the timing and dosage of immunosuppression in accordance with two therapeutic principles: recipient pretreatment, and minimum use of post-transplant immunosuppression. We aimed to apply these principles in recipients of renal and extrarenal organ transplants.
methods82 patients awaiting kidney, liver, pancreas, or intestinal transplantation were pretreated with about 5 mg/kg of a broadly reacting rabbit antithymocyte globulin during several hours. Post-transplant immunosuppression was restricted to tacrolimus unless additional drugs were needed to treat breakthrough rejection. After 4 months, patients on tacrolimus monotherapy were considered for dose-spacing to every other day or longer intervals.
findingsWe frequently saw evidence of immune activation in graft biopsy samples, but unless this was associated with graft dysfunction or serious immune destruction, treatment usually was not intensified. Immunosuppression-related morbidity was virtually eliminated. 78 (95%) of 82 patients survived at 1 year and at 13-18 months. Graft survival was 73 (89%) of 82 at 1 year and 72 (88%) of 82 at 13-18 months. Of the 72 recipients with surviving grafts, 43 are on spaced doses of tacrolimus monotherapy: every other day (n=6), three times per week (11), twice per week (15), or once per week (11).
interpretationThe striking ability to wean immunosuppression in these recipients indicates variable induction of tolerance. The simple therapeutic principles are neither drug-specific nor organ-specific. Systematic application of these principles should allow improvements in quality of life and long-term survival after organ transplantation.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.