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
AUTHORS (6)
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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