000			na a22 4500
999			_c566 _d566
003			PC566
005			20210706062652.0
008			130622s2013 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_aDelgado Jiménez, Juan Francisco _91250 _eCardiología
245	0	0	_aRejection after conversion to a proliferation signal inhibitor in chronic heart transplantation. _h[artículo]
260			_bClinical Transplantation, _c2013
300			_a27(6):E649-58.
500			_aFormato Vancouver: González-Vílchez F, Vázquez de Prada JA, Paniagua MJ, Almenar L, Mirabet S, Gómez-Bueno M et al. Rejection after conversion to a proliferation signal inhibitor in chronic heart transplantation. Clin Transplant. 2013 Nov-Dec;27(6):E649-58.
501			_aPMID: 24025040
504			_aContiene 25 referencias
520			_aWe sought to determine the incidence, risk factors, and consequences of acute rejection (AR) after conversion from a calcineurin inhibitor (CNI) to a proliferation signal inhibitor (PSI) in maintenance heart transplantation. Relevant clinical data were retrospectively obtained for 284 long-term heart transplant recipients from nine centers in whom CNIs were replaced with a PSI (sirolimus or everolimus) between October 2001 and March 2009. The rejection rate at oneyr was 8.3%, stabilizing to 2% per year thereafter. The incidence rate after conversion (4.9 per 100 patient-years) was significantly higher than that observed on CNI therapy in the pre-conversion period (2.2 per 100 patient-years). By multivariate analysis, rejection risk was associated with a history of late AR prior to PSI conversion, early conversion (<5yr) after transplantation and age <50yr at the time of conversion. Use of mycophenolate mofetil was a protective factor. Post-conversion rejection did not significantly influence the evolution of left ventricular ejection fraction, renal function, or mortality during further follow-up. Conversion to a CNI-free immunosuppression based on a PSI results in an increased risk of AR. Awareness of the clinical determinants of post-conversion rejection could help to refine the current PSI conversion strategies.
710			_9119 _aServicio de Cardiología
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/5/pc566.pdf _ySolicitar documento
942			_n0 _2ddc _cART