Open AccessLong‐term results of a prospective randomized study comparing two immunosuppressive regimens, one with and one without CsA, in low‐risk renal transplant recipients
Author(s) -
Grimbert Philippe,
Baron Christophe,
Fruchaud Ghislaine,
Hemery François,
Desvaux Dominique,
Buisson Claude,
Chopin Dominique,
Dahmane Djamel,
Remy Philippe,
Pastural Myriam,
Abbou Claude,
Weil Bertrand,
Lang Philippe
Publication year - 2002
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/j.1432-2277.2002.tb00106.x
Subject(s) - medicine , azathioprine , calcineurin , prednisone , nephrotoxicity , creatinine , renal function , gastroenterology , regimen , transplantation , surgery , kidney transplantation , urology , kidney , disease
Due to the nephrotoxicity of cyclosporin A (CsA), its benefit on long‐term graft survival remains controversial, especially in low‐risk patients. Here we report the 12‐year results of a calcineurin‐inhibitor‐free regimen. One hundred and seventeen low‐risk kidney recipients were prospectively randomized to maintenance therapy with either a combination of azathioprine and prednisone (group NoCsA, n = 58), or with cyclosporine, azathioprine, and prednisone (group CsA, n = 59). Both groups received induction therapy with anti‐lymphocyte globulins (ALG). Twelve‐year patient survival was 75% and 82.5% in the CsA and NoCsA groups, respectively [ P = not significant (NS)]. Twelve‐year graft survival was 59% and 56% ( P = NS) in the CsA and NoCsA groups, respectively (NS). Transplant rejection rates were similar in both groups. Mean serum creatinine levels after 10 years were 161 and 136 μmol/I in the CsA and NoCsA groups, respectively. Rejection‐free patients of the CsA group had poorer renal function (168 μmol/I) than those of the NoCsA group (121 μmol/I; P = 0.0060). We concluded that a 12‐year graft survival of 56% and a graft half‐life of 15 years can be achieved without the primary use of a calcineurin inhibitor in low‐risk patients receiving ALG. Patients treated with CsA had poorer graft function at 12 years.