{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T10:33:31Z","timestamp":1772447611230,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,3,14]],"date-time":"2016-03-14T00:00:00Z","timestamp":1457913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is a lack of conclusive evidence to suggest if calcineurin inhibitor (<jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>) withdrawal or minimization with sirolimus is the best strategy for African Americans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a randomized, prospective, open\u2010label, pilot study comparing the two mammalian target of rapamycin (<jats:styled-content style=\"fixed-case\">mTOR<\/jats:styled-content>) transition strategies in adult African Americans between six and 24 wk post\u2010transplant. The primary outcome was a comparison of the <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> at one yr after conversion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty patients were randomized and analyzed in an intent\u2010to\u2010treat fashion. Median day of transition was day 96 (withdrawal) and 68 (minimization). Patients in the <jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>\u2010withdrawal group (n = 23) had significantly higher <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> at one yr compared to the <jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>\u2010minimization group (n = 17, 73 vs. 56 mL\/min, p = 0.03), as well as a significantly larger increase in <jats:styled-content style=\"fixed-case\">eGFR<\/jats:styled-content> from baseline (12 vs. 5 mL\/min, p = 0.03). There were no differences in infections, acute rejection, death, or graft loss. Both regimens were constrained by disproportionately high discontinuation rates despite modest toxicity profiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In spite of considerable withdrawal rate across both study arms, African American kidney transplant recipients who underwent early transition to a sirolimus\u2010based <jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>\u2010withdrawal regimen had significantly better graft function at one yr compared to those transitioned to a sirolimus\u2010based <jats:styled-content style=\"fixed-case\">CNI<\/jats:styled-content>\u2010minimization regimen. Clinicaltrials.gov identifier: <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>01005706.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12718","type":"journal-article","created":{"date-parts":[[2016,2,26]],"date-time":"2016-02-26T03:16:45Z","timestamp":1456456605000},"page":"528-533","source":"Crossref","is-referenced-by-count":10,"title":["A randomized, prospective comparison of transition to sirolimus\u2010based <scp>CNI<\/scp>\u2010minimization or withdrawal in African American kidney transplant recipients"],"prefix":"10.1111","volume":"30","author":[{"given":"James N.","family":"Fleming","sequence":"first","affiliation":[{"name":"Department of Pharmacy Services Medical University of South Carolina Charleston SC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Taber","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina Charleston SC USA"},{"name":"Department of Pharmacy Ralph H Johnson VAMC Charleston SC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole A.","family":"Pilch","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services Medical University of South Carolina Charleston SC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"McGillicuddy","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina Charleston SC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Titte R.","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Department of Nephrology Medical University of South Carolina Charleston SC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhakar K.","family":"Baliga","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina Charleston SC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth D.","family":"Chavin","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina Charleston SC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles F.","family":"Bratton","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina Charleston SC 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