BACKGROUND: In order to decrease the rate of adverse effects of cyclosporin, a low-dose CsA plus MMF and Pred triple immunosuppressive protocol was started from 1996. The purpose of this study was to evaluate the efficacy and safety of low-dose cyclosporin plus MMF and Pred triple immunosuppressive protocol in renal transplantation. METHODS: 2162 renal transplant recipients were included in our prospective study, all patients received CsA plus MMF and Pred triple immunosuppressive protocol. According to CsA dose, they were divided into two groups. In group A, low-dose CsA (n=1865, started dose at 4.0∼4.5mg/kg/d, maintenance dose at 2.0∼3.0 mg/kg/d) plus MMF and Pred were used. In group B, normal-dose CsA (n=297, started dose at 6.0∼8.0mg/kg/d, maintenance dose at 3.5∼4.5 mg/kg/d) plus MMF and Pred were utilized. Patients were followed up for a minimum of 12 months. We monitored changes of blood concentrations of CsA in the two different patient treatment groups for post-transplant patient and graft survival rates, graft function, episodes of acute rejection, and hepatic and renal toxicity. RESULTS: One-year and five-year patient / graft survival rates were not significantly different between group A (96.1/92.2,87.8/80.6) and group B (95.3%/91.1%, 83.2%/78.1%), respectively (p>0.05). The blood concentrations of CsA of group A were lower than those of control group B (P < 0.01). The two groups had similar rates of acute rejection (7.8 vs. 8.3%, p> 0.05), Statistically significant better renal function was encountered among group A patients at three years post-transplantation as measured by serum creatinine (108.5 vs. 136.7 Μmol/L, P< 0.01). The incidence of new onset diabetes was 11.4% in group A and 20.2% in group B (P< 0.01). Nephrotoxicity and hepatotoxicity were seen in 11.2%, 7.8% of group A and 25.3%, 22.6% of group B, respectively (p<0.01). CONCLUSIONS: Low-dose CsA plus MMF and Pred triple immunosuppressive protocol could improve primary and long-term kidney function by promoting the recovery of graft function and decreasing hepatic and renal toxicity while lightening the patients' economic burden. Compared with normal-dose CsA, low-dose CsA is effective, relatively safe and well tolerated in renal transplant recipients.
To cite this abstract in AMA style:Xiang H, Xue W, Tian P, Ding X, Pan X, Yan H, Hou J, Feng X, Tian X, Ding C. Low-Dose Cyclosporine (CsA) Plus Mycophenolate Mofetil (MMF) and Prednisolone (Pred) Triple Immunosuppressive Protocol in Renal Transplantation [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/low-dose-cyclosporine-csa-plus-mycophenolate-mofetil-mmf-and-prednisolone-pred-triple-immunosuppressive-protocol-in-renal-transplantation/. Accessed June 23, 2018.
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