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Tacrolimus plus mycophenolate mofetil vs. cyclosporine plus everolimus in deceased donor kidney transplant recipients: three‐yr results of a single‐center prospective clinical trial
Author(s) -
Favi Evaldo,
Spagnoletti Gionata,
Salerno Maria P.,
Pedroso José A.,
Romagnoli Jacopo,
Citterio Franco
Publication year - 2013
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12141
Subject(s) - medicine , everolimus , tacrolimus , basiliximab , regimen , urology , discontinuation , mycophenolic acid , gastroenterology , renal function , sirolimus , single center , transplantation , kidney transplantation , mycophenolate , immunosuppression , calcineurin , surgery
Abstract We 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.