Bibliographic record
Abstract
Introduction: Late onset renal impairment after liver transplantation is a major cause of end-stage renal disease and a risk factor for death.One of the risk factors for late-onset renal impairment is the dose and level of the calcineurin inhibitor during the early months after transplantation.Renal function at one year predicts longer-term renal function.Aim: we did a prospective randomised study to determine whether lower levels with or without delayed introduction of tacrolimus was associated with less renal impairment (as assessed by the Cockcroft-Gault formula) and no adverse effect on patient or graft.Methods: 525 adult recipients of a first graft were randomised to one of three groups in 30 European centers: group A: tacrolimus at the recommended dose (to achieve target levels ≥10ng/mL for the first month (n=183); group B: tacrolimus at a lower dose (trough target levels <8ng/mL for the first month and mycophenolate mofetil 2g/day (n=170) and group C: daclizumab on day 1 and 7, mycophenolate mofetil 2g/day and tacrolimus introduced on day 5 with trough target levels <8ng/mL).Corticosteroids were given according to local practice in each group.Results: Calculated GFR was 103, 107 and 98 mL/min in groups A, B and C at the start of the study and fell by 25, 24 and 17 mL/min at one year; the difference between A and C was statistically significant (p=0.003).Withdrawals because of adverse events occurred in 29, 18 and 21% and, as a sub-category, withdrawal related to renal impairment occurred in 12, 2 and 1% of the patients.At one year, patient death occurred in 9.2, 10 and 5% respectively and graft loss was 6.0, 5.9 and 6.6% respectively; dialysis was required in 17, 10 and 9% respectively during the first year: there was no difference in the incidence of biopsy-proven acute rejection (31, 30 and 25%).Diarrhoea occurred in 21, 31 and 25%.Conclusions: this study suggests that lower and delayed introduction of tacrolimus together with mycophenolate mofetil and daclizumab is associated with better preservation of renal function at one year without any significant adverse impact on patient or graft.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.599 | 0.267 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".