Evidence map›Paper›PMID 23432755›Full record

Trial reportAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2013

Prospective randomized trial of maintenance immunosuppression with rapid discontinuation of prednisone in adult kidney transplantation.

T M Suszynski, K J Gillingham, M D Rizzari, T B Dunn, W D Payne, S Chinnakotla, E B Finger, D E R Sutherland, J S Najarian, T L Pruett and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Article
  8. Article
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  11. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

T M SuszynskiDepartment of Surgery, University of Minnesota, Minneapolis, MN.
K J GillinghamDepartment of Surgery, University of Minnesota, Minneapolis, MN.
M D RizzariDepartment of Surgery, University of Minnesota, Minneapolis, MN.
T B DunnDepartment of Surgery, University of Minnesota, Minneapolis, MN.
W D PayneDepartment of Surgery, University of Minnesota, Minneapolis, MN.
S ChinnakotlaDepartment of Surgery, University of Minnesota, Minneapolis, MN.
E B FingerDepartment of Surgery, University of Minnesota, Minneapolis, MN.
D E R SutherlandDepartment of Surgery, University of Minnesota, Minneapolis, MN.
J S NajarianDepartment of Surgery, University of Minnesota, Minneapolis, MN.
T L PruettDepartment of Surgery, University of Minnesota, Minneapolis, MN.
A J MatasDepartment of Surgery, University of Minnesota, Minneapolis, MN.
R KandaswamyDepartment of Surgery, University of Minnesota, Minneapolis, MN.

Funding

Viral Infections and Posttransplant MorbidityP01DK013083 · NIDDK · UNIVERSITY OF MINNESOTA TWIN CITIES · PI MATAS, ARTHUR J · 1986 to 2013
$14.9M
NIDDK NIH HHS P01 DK013083
6 · The paper itself

Abstract

Rapid discontinuation of prednisone (RDP) has minimized steroid-related complications following kidney transplant (KT). This trial compares long-term (10-year) outcomes with three different maintenance immunosuppressive protocols following RDP in adult KT. Recipients (n=440; 73% living donor) from March 2001 to April 2006 were randomized into one of three arms: cyclosporine (CSA) and mycophenolate mofetil (MMF) (CSA/MMF, n=151); high-level tacrolimus (TAC, 8-12 μg/L) and low-level sirolimus (SIR, 3-7 μg/L) (TACH/SIRL, n=149) or low-level TAC (3-7 μg/L) and high-level SIR (8-12 μg/L) (TACL/SIR(H) , n=140). Median follow-up was ∼7 years. There were no differences between arms in 10-year actuarial patient, graft and death-censored graft survival or in allograft function. There were no differences in the 10-year actuarial rates of biopsy-proven acute rejection (30%, 26% and 20% in CSA/MMF, TACH/SIRL and TACL/SIRH) and chronic rejection (38%, 35% and 31% in CSA/MMF, TACH/SIRL and TACL/SIRH). Rates of new-onset diabetes mellitus were higher with TACH/SIRL (p=0.04), and rates of anemia were higher with TACH/SIRL and TACL/SIRH (p=0.04). No differences were found in the overall rates of 16 other post-KT complications. These data indicate that RDP-based protocol yield acceptable 10-year outcomes, but side effects differ based on the maintenance regimen used and should be considered when optimizing immunosuppression following RDP.

Indexed as

AdultCyclosporineDiabetes Mellitus, Type 1FemaleHumansImmunosuppression TherapyImmunosuppressive AgentsKidney TransplantationLiving DonorsMaleMiddle AgedMycophenolic AcidPostoperative ComplicationsPrednisoneProspective StudiesSirolimusCyclosporineImmunosuppressive AgentsMycophenolic AcidPrednisoneSirolimusSteroidsTacrolimus

Identifiers

PMID23432755
PMCPMC3621067

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

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.