ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2016
National Variation in Use of Immunosuppression for Kidney Transplantation: A Call for Evidence-Based Regimen Selection.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Survival of kidney transplantation in people living with HIV/AIDS: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Effectiveness of T cell-mediated rejection therapy: A systematic review and meta-analysis.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Pooled it
- Torque Teno Virus in Kidney Transplant Recipients: Perspectives on Its Role as a Complementary Marker in Monitoring Net Immunosuppression.Journal of clinical medicine · 2026Review
- The Impact of Recipient HIV Status on Kidney Transplant Outcomes in the United Kingdom: Have Previous Studies Overestimated Risk?Transplantation · 2026Article
- A population-based analysis of immunosuppression therapy after organ transplantation.BMC health services research · 2025Article
- Infection Risk in Older Kidney Transplant Recipients: An Analysis in the Era of Expanded Age Limits.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
- Immunosuppression regimen and latitude impact keratinocyte carcinoma risk in U.S. liver transplant recipients.Archives of dermatological research · 2024Article
- HLA-DR/DQ eplet mismatch predictsFrontiers in genetics · 2024Article
- Determinants of immunosuppressive therapy in renal transplant recipients: an Italian observational study (the CESIT project).BMC nephrology · 2023Observational
- Tacrolimus induces a pro-fibrotic response in donor-derived human proximal tubule cells dependent on common variants of the CYP3A5 and ABCB1 genes.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- Utility of salivary mycophenolic acid concentration monitoring: Modeling and Monte Carlo validation approach.Pharmacology research & perspectives · 2022Article
- Kidney Transplantation, Immunosuppression and the Risk of Fracture: Clinical and Economic Implications.Kidney medicine · 2022Article
- Temporal and spatial variability of immunosuppressive therapies in transplant patients: An observational study in Italy.Frontiers in transplantation · 2022Article
- An Italian multicentre distributed data research network to study the use, effectiveness, and safety of immunosuppressive drugs in transplant patients: Framework and perspectives of the CESIT project.Frontiers in pharmacology · 2022Article
- Immunosuppression Regimen Use and Outcomes in Older and Younger Adult Kidney Transplant Recipients: A National Registry Analysis.Transplantation · 2021Article
- Clinical significance of tacrolimus intra-patient variability on kidney transplant outcomes according to pre-transplant immunological risk.Scientific reports · 2021Article
- Inconsistencies in the association of clinical factors with the choice of early steroid withdrawal across kidney transplant centers: A national registry study.Clinical transplantation · 2021Article
- Adequate tacrolimus exposure modulates the impact of HLA class II molecular mismatch: a validation study in an American cohort.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Renoprotective Effects of Alpha-1 Antitrypsin against Tacrolimus-Induced Renal Injury.International journal of molecular sciences · 2020Article
- Sensitization in transplantation: Assessment of risk (STAR) 2019 Working Group Meeting Report.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Review
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Immunosuppression management in kidney transplantation has evolved to include an increasingly diverse choice of medications. Although informed by patient and donor characteristics, choice of immunosuppression regimen varies widely across transplant programs. Using a novel database integrating national transplant registry and pharmacy fill records, immunosuppression use at 6-12 and 12-24 mo after transplant was evaluated for 22 453 patients transplanted in 249 U.S. programs in 2005-2010. Use of triple immunosuppression comprising tacrolimus, mycophenolic acid or azathioprine, and steroids varied widely (0-100% of patients per program), as did use of steroid-sparing regimens (0-77%), sirolimus-based regimens (0-100%) and cyclosporine-based regimens (0-78%). Use of triple therapy was more common in highly sensitized patients, women and recipients with dialysis duration >5 years. Sirolimus use appeared to diminish over the study period. Patient and donor characteristics explained only a limited amount of the observed variation in regimen use, whereas center choice explained 30-46% of the use of non-triple-therapy immunosuppression. The majority of patients who received triple-therapy (79%), cyclosporine-based (87.6%) and sirolimus-based (84.3%) regimens continued them in the second year after transplant. This population-based study of immunosuppression practice demonstrates substantial variation in center practice beyond that explained by differences in patient and donor characteristics.
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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.