Analysis of the difference in estimated GFR (eGFR) of living donor recipient pairs at six months post-transplant showed that increased use of tacrolimus and MPA derivative maintenance immunosuppression reduced the difference in the last decade. This study sought to understand the impact of tacrolimus and MPA derivatives on this difference in recipients without rejection by selecting adult gender concordant sibling donor recipient pairs who did not experience delayed graft function or rejection in the first six months and were treated with tacrolimus and MPA derivatives. Gender concordant sibling pairs were selected to minimize differences in age and size. Between January 1, 2000 to August 31, 2013 3708 pairs were identified in the SRTR database. eGFR was calculated for the donor and recipient using the CKD EPI equation. The distribution of eGFR at six month for the donors and recipients were very similar. Table one shows the comparative differences between the donor and recipient based on gender group. Sibling donors were slightly younger, taller and heavier than their recipients. The percent HLA identical transplants and retransplants were slightly higher among female recipients while diabetes as a cause of ESRD was higher among male recipients. Rates of induction use were similar. The mean difference in eGFR for the entire cohort was 0.90 ml/min/1.73m2. The difference was 2.31 mL/min/1.73m2 and -0.65 mL/min/1.73m2 for female and male pairs respectively. Adjusting for the above covariates with linear regression showed male pairs had a 0.54 mL/min/1.73m2 difference while the female pairs had difference of 3.47 mL/min/1.73m2. This analysis suggests that in an uncomplicated living donor kidney transplant treated with tacrolimus and MPA results in a 5% or less reduction in eGFR.

CITATION INFORMATION: Keith D. The Impact of Tacrolimus and MPA Derivative Immunosuppression on Acheived GFR in Recipients without Rejection: A Comparison of GFR of Living Donor Recipient Pairs at Six Months Post-Transplant. Am J Transplant. 2017;17 (suppl 3).

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