Evidence map›Paper›PMID 39938661›Full record

ArticleRespiratory medicine2025

Outcomes in lung transplant recipients on azathioprine compared to mycophenolate.

David M Sanborn, Joelle N Friesen, Hemang Yadav, Cassie C Kennedy, Mark E Wylam, Steve G Peters, John P Scott, Sahar A Saddoughi, Kelly M Pennington

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Respiratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. European society for organ transplantation clinical practice guideline on prevention and treatment of chronic lung allograft dysfunction.Transplant international : official journal of the European Society for Organ Transplantation · 2026
    Guideline
  2. Review
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

9 authors.

David M SanbornDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA. Electronic address: Sanborn.David@mayo.edu.
Joelle N FriesenDepartment of Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA. Electronic address: Friesen.Joelle@mayo.edu.
Hemang YadavDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA. Electronic address: Yadav.Hemang@mayo.edu.
Cassie C KennedyDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Electronic address: Kennedy.Cassie@mayo.edu.
Mark E WylamDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Electronic address: Wylam.Mark@mayo.edu.
Steve G PetersDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Electronic address: peters.steve@mayo.edu.
John P ScottDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Electronic address: scott.john@mayo.edu.
Sahar A SaddoughiWilliam J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA; Division of Thoracic Surgery & Department of Cardiovascular Surgery, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA. Electronic address: Saddoughi.Sahar-Al-Sadat@mayo.edu.
Kelly M PenningtonDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St. SW Rochester, MN, 55905, USA; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. Electronic address: pennington.kelly@mayo.edu.

Funding

Predicting and Preventing Acute Respiratory Distress Syndrome after Hematopoietic Stem Cell TransplantationK23HL151671 · NHLBI · MAYO CLINIC ROCHESTER · PI YADAV, HEMANG · 2021 to 2025
$813k
NHLBI NIH HHS K23 HL151671
6 · The paper itself

Abstract

introA three-drug immunosuppression regimen to prevent graft loss is the cornerstone of therapy following lung transplantation. Direct comparisons between maintenance regimens including mycophenolate (MMF) and azathioprine (AZA) are limited in the lung transplant population.

methodsWe completed a retrospective cohort study of adult (≥18 years of age) lung transplant recipients at Mayo Clinic (Rochester, MN) from January 1, 2009 through July 1, 2022 and compared outcomes in patients on AZA vs MMF. Our primary outcome was clinically significant acute cellular rejection. Secondary outcomes included graft loss, drug interruption, chronic lung allograft dysfunction (CLAD), and infection. Analyses were performed with Multivariable Cox Regression with transplant era and induction immunosuppression agent as covariables.

results224 patients were included, 88 on AZA and 136 on MMF. The risk of clinically significant rejection was greater in the AZA group compared to the MMF group (HR, 1.76; 95 % CI 1.12-2.79; P = 0.02). Medication interruption was also higher in the AZA (HR, 1.47; 95 % CI 1.04-2.08; P = 0.026). Rates of CLAD, graft loss, and infection were similar between the groups.

conclusionIn this cohort, MMF was associated with lower risk of clinically significant acute cellular rejection and drug interruption when compared to AZA. Similar rates of CLAD, graft loss, and infection were observed.

Indexed as

AzathioprineGraft RejectionImmunosuppressive AgentsLung TransplantationMycophenolic AcidAdultFemaleHumansMaleMiddle AgedRetrospective StudiesTransplant RecipientsTreatment OutcomeAzathioprineImmunosuppressive AgentsMycophenolic AcidChronic lung allograft dysfunctionImmunosuppressionInfectionLung transplantRejection

Identifiers

PMID39938661
PMCPMC11931559

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Registered trials

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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.