Tacrolimus plus mycophenolate mofetil vs. cyclosporine plus everolimus in deceased donor kidney transplant recipients: three‐yr results of a single‐center prospective clinical trial

• DOI: 10.1111/ctr.12141
• Publication Date: 2013-05-27T01:52:48Z
• Authors: Evaldo Favi; Gionata Spagnoletti; Maria P. Salerno; José A. Pedroso; Jacopo Romagnoli; Franco Citterio
• Keywords: Adult; Graft Rejection; Male; deceased donor kidney transplant; Acute rejection; Cyclosporine; Everolimus; Immunosuppression; Kidney transplantation; Tacrolimus; Adult; Case-Control Studies; Cyclosporine; Delayed Graft Function; Drug Therapy, Combination; Dyslipidemias; Everolimus; Female; Follow-Up Studies; Glomerular Filtration Rate; Graft Rejection; Graft Survival; Humans; Immunosuppressive Agents; Kidney Failure, Chronic; Kidney Function Tests; Kidney Transplantation; Male; Middle Aged; Mycophenolic Acid; Prognosis; Prospective Studies; Risk Factors; Sirolimus; Survival Rate; Tacrolimus; Tissue Donors; Young Adult; Postoperative Complications; Delayed Graft Function; Kidney Function Tests; 03 medical and health sciences; 0302 clinical medicine; Humans; Everolimus; Dyslipidemias; Graft Survival; Middle Aged; Mycophenolic Acid; everolimus; Kidney Transplantation; 3. Good health; Case-Control Studies; Cyclosporine; Kidney Failure, Chronic; Drug Therapy, Combination; Female; Immunosuppressive Agents; Follow-Up Studies; Glomerular Filtration Rate

AbstractWe compared in kidney transplantation two immunosuppressive regimens: tacrolimus plus mycophenolate mofetil (MMF) (TAC) and everolimus plus low‐dose cyclosporine (EVE). Sixty consecutive patients received TAC (30 patients) or EVE (30 patients) as immunosuppressive regimen; all subjects also received induction with basiliximab and corticosteroids. After three‐yr follow‐up, no difference was found in patient and graft survival (PTS: TAC: 97% vs. EVE: 100%; GS: TAC: 93% vs. EVE: 93%). The incidence of acute rejection was higher in the EVE group but the difference was not statistically significant (17% vs. 23%, p = ns). Patients in EVE showed higher serum cholesterol (205 ± 41 vs. 235 ± 41 mg/dL, p = 0.0012) and lower hemoglobin concentration (13.6 ± 1.4 vs. 12.4 ± 1.9, p = 0.01). Renal function was not significantly different in the two groups (3 Y creatinine: TAC 1.4 ± 0.8 vs. EVE 1.6 ± 0.8 mg/dL, p = ns). Treatment discontinuation was higher in the EVE group (TAC 17 vs. EVE 36%, p = ns). Our data show that in the middle‐term follow‐up, an immunosuppressive regimen with tacrolimus plus MMF has a similar efficacy and safety profile in comparison with the combination of low‐exposure cyclosporine plus everolimus. Further follow up could evidence the benefits related to the anti‐proliferative effects of everolimus.