Open AccessTacrolimus and mycophenolate regimen and subclinical tubulo‐interstitial inflammation in low immunological risk renal transplants
Author(s) -
Torres Irina B.,
Reisæter Anna V.,
Moreso Francesc,
Âsberg Anders,
Vidal Marta,
GarciaCarro Clara,
Midtvedt Karsten,
Reinholt Finn P.,
Scott Helge,
Castellà Eva,
Salcedo Maite,
Dörje Christina,
Sellarés Joana,
Azancot Maria A.,
Perello Manel,
Holdaas Hallvard,
Serón Daniel
Publication year - 2017
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13002
Subject(s) - medicine , subclinical infection , tacrolimus , cohort , gastroenterology , immunosuppression , urology , mycophenolic acid , transplantation , surgery
Summary The aim was to evaluate the relationship between maintenance immunosuppression, subclinical tubulo‐interstitial inflammation and interstitial fibrosis/tubular atrophy ( IF / TA ) in surveillance biopsies performed in low immunological risk renal transplants at two transplant centers. The Barcelona cohort consisted of 109 early and 66 late biopsies in patients receiving high tacrolimus ( TAC ‐C 0 target at 1‐year 6–10 ng/ml) and reduced MMF dose (500 mg bid at 1‐year). The Oslo cohort consisted of 262 early and 237 late biopsies performed in patients treated with low TAC ‐C 0 (target 3–7 ng/ml) and standard MMF dose (750 mg bid). Subclinical inflammation, adjusted for confounders, was associated with low TAC ‐C 0 in the early ( OR : 0.75, 95% CI : 0.61–0.92; P = 0.006) and late biopsies ( OR : 0.69, 95% CI : 0.50–0.95; P = 0.023) from Barcelona. In the Oslo cohort, it was associated with low MMF in early biopsies ( OR : 0.90, 95% CI : 0.83–0.98; P = 0.0101) and with low TAC ‐C 0 in late biopsies ( OR : 0.77, 95% CI : 0.61–0.97; P = 0.0286). MMF dose was significantly reduced in Oslo between early and late biopsies. IF / TA was not associated with TAC ‐C 0 or MMF dose in the multivariate analysis. Our data suggest that in TAC ‐ and MMF ‐based regimens, TAC ‐C 0 levels are associated with subclinical inflammation in patients receiving reduced MMF dose.