AIM： To study the long-term outcome of ketoconazole and tacrolimus combination in kidney transplant recipi-ents. METHODS： From 2006 to 2010, ketoconazole was given in 199 patients and was continued for at least 1 y...AIM： To study the long-term outcome of ketoconazole and tacrolimus combination in kidney transplant recipi-ents. METHODS： From 2006 to 2010, ketoconazole was given in 199 patients and was continued for at least 1 year or until graft failure （Group 1）, while 149 patients did not receive any ketoconazole （Group 2）. A combina-tion of tacrolimus, mycophenolate and steroid was used as maintenance therapy. High risk patients received basiliximab induction. RESULTS： Basic demographic data was similar be-tween the 2 groups. The 5-year cumulative incidence of biopsy-confrmed and clinically-treated acute rejection was signifcantly higher in Group 1 than in Group 2 （34% vs 18%, P = 0.01）. The 5-year Kaplan-Meier estimated graft survival （74.3% vs 76.4%, P = 0.58） and patient survival （87.8% vs 87.5%, P = 0.93） were not different between the 2 groups. Multivariable analyses identifed ketoconazole usage as an independent risk of acute rejection （HR = 2.33, 95%CI： 1.33-4.07; P = 0.003） while tacrolimus dose in the 2nd month was protective （HR = 0.89, 95%CI： 0.75-0.96; P = 0.041）. CONCLUSION： Co-administration of ketoconazole and tacrolimus is associated with significantly higher inci-dence of acute rejection in kidney transplant recipients.展开更多
文摘AIM： To study the long-term outcome of ketoconazole and tacrolimus combination in kidney transplant recipi-ents. METHODS： From 2006 to 2010, ketoconazole was given in 199 patients and was continued for at least 1 year or until graft failure （Group 1）, while 149 patients did not receive any ketoconazole （Group 2）. A combina-tion of tacrolimus, mycophenolate and steroid was used as maintenance therapy. High risk patients received basiliximab induction. RESULTS： Basic demographic data was similar be-tween the 2 groups. The 5-year cumulative incidence of biopsy-confrmed and clinically-treated acute rejection was signifcantly higher in Group 1 than in Group 2 （34% vs 18%, P = 0.01）. The 5-year Kaplan-Meier estimated graft survival （74.3% vs 76.4%, P = 0.58） and patient survival （87.8% vs 87.5%, P = 0.93） were not different between the 2 groups. Multivariable analyses identifed ketoconazole usage as an independent risk of acute rejection （HR = 2.33, 95%CI： 1.33-4.07; P = 0.003） while tacrolimus dose in the 2nd month was protective （HR = 0.89, 95%CI： 0.75-0.96; P = 0.041）. CONCLUSION： Co-administration of ketoconazole and tacrolimus is associated with significantly higher inci-dence of acute rejection in kidney transplant recipients.
