A Novel Maintenance Regimen With Calcineurin Inhibitor, MMF and Everolimus Initiated By Dual Induction Therapy With Anti-CD20/25 Antibodies in Renal Transplantation

N. Masaki, K. Iwado, I. Nakagima, S. Fuchinoue.

Surgery III, Tokyo Women's Medical University Hospital, Shinjuku-ku,Tokyo, Japan.

Meeting: 2015 American Transplant Congress

Abstract number: A156

Keywords: Graft survival, Immunosuppression, Kidney transplantation, Outcome

Session Information

Session Name: Poster Session A: Kidney Immunosuppression: Induction Therapy

Session Type: Poster Session

Date: Saturday, May 2, 2015

Session Time: 5:30pm-7:30pm

Presentation Time: 5:30pm-7:30pm

Location: Exhibit Hall E

【background】Calcineurin inhibitor (CNI), MMF and steroid has been the gold standard of maintenance regimen in renal transplantation (RTx). A line of new immunosuppressants has emerged around the same time, including anti-CD25 antibody (basiliximax:BXM), anti-CD20 antibody (rituximab:RXM) and mTOR inihibitor (everolimus:EVR). We report a novel regimen in RTx using these drugs and its clinical results.

【method】We have adopted three different regimens in RTx. In 2011, we used a conventional regimen composed of CNI, MMF and steroid initiated by RXM (R1). In 2012, a new regimen composed of CNI, EVR and steroid with dual induction of BXM and RXM (R2) was applied. In 2013, we took another regimen that was initiated as CNI, MMF and steroid with the dual induction and that the steroid was converted for EVR after 2 to 3 weeks postoperatively (R3). Their clinical parameters were compared, including serum creatinine (sCr) level, biopsy proven acute rejection (BPAR) free ratio and graft survival rate.

【results】The sCr levels (mg/dl) of R1 (n=49) vs. R2 (n=53) vs. R3 (n=25) at 1, 6, 12 months after surgery were 1.7±1.6 vs. 1.8±0.14 vs. 1.9±0.91, 1.3±0.38 vs. 2.6±0.56 vs. 1.2±0.24, 1.2±0.38 vs. 1.7±0.50 vs. 1.1±0.40, respectively (p<0.05).1-year BPAR free ratios of them were 87.8% vs. 98.0% vs. 100%, respectively (p>0.05). 1-year graft survival rates of them were 97.9% vs. 95.1% vs. 100%, respectively (p>0.05).

【conclusione】We conclude that the new regimen R3 revealed the best short term clinical results with good renal function and low rate BPAR accompanied by steroid free and mTOR inhibitor add-on therapy and that it might have a possibility to become another standard regimen in RTx.

To cite this abstract in AMA style:

Masaki N, Iwado K, Nakagima I, Fuchinoue S. A Novel Maintenance Regimen With Calcineurin Inhibitor, MMF and Everolimus Initiated By Dual Induction Therapy With Anti-CD20/25 Antibodies in Renal Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/a-novel-maintenance-regimen-with-calcineurin-inhibitor-mmf-and-everolimus-initiated-by-dual-induction-therapy-with-anti-cd2025-antibodies-in-renal-transplantation/. Accessed May 19, 2025.

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