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

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
DOI: 10.1111/ctr.12141 Publication Date: 2013-05-27T01:52:48Z
ABSTRACT
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.
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