Calcineurin Inhibitor-Free Immunossupresion After Kidney Transplantation, Using Everolimus De Novo – Single Center Experience
Department of Transplantology, General, Vascular and Plastic Surgery, Clinical Hospital of Poznan University of Medical Sciences, Poznan, Poland.
Meeting: 2015 American Transplant Congress
Abstract number: D146
Keywords: Calcineurin, Immunosuppression, Kidney transplantation, Rapamycin
Session Information
Session Name: Poster Session D: Kidney Immunosuppression: Drug Minimization
Session Type: Poster Session
Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
The aim of the study was to analyse the clinical outcome in kidney transplant recipients treated with CNI (calcineurin inhibitors)-free protocol versus kidney transplant recipients treated with CNI in our hospital.
Recipients of renal transplant from deceased donors in whom transplantation was performed from June 2013 to November 2014 were included in the study. At baseline, 100 patients were treated with CNI (tacrolimus or cyclosporine A), steroids, and MMF/MPA (CNI group), and 20 patients (9 women, 11 men) received CNI-free protocol, based on everolimus, steroids, MMF/MPA, and basiliximab induction (CNIF group).
Inclusion criteria for CNI-free protocol using de novo mTOR inhibitors were: precancerous conditions or cancers in the medical history of recipients such as colon, laryngeal and gastric polyps (5), breast, testicular, renal cancer (4), benign tumors of the ovary, uterus, thyroid gland, meningioma (6); micropathy in recipients (2), tuberous sclerosis in recipient (1) and fibro-muscular dysplasia in donors (2).
Mean follow-up of the CNIF group was 6 months. Delayed graft function (DGF), occured in 2 patients, lymphocele- in 3 patients, leukopenia- in 1, diarrhea and other gastro-intestinal disorders- in 4. Acute graft rejection, acute tubular necrosis, diabetes de novo, viral infections, dyslipidemia, liver failure have not been observed in any of the CNIF patients. Mean systolic blood pressure was 128.9 +/- 14.5 and diastolic- 80 +/- 11.1 mmHg.
Wound infections, poor wound healing and bacterial infections occurred with comparable frequency in both groups but results lacked sufficient statistical power. The primary end point was estimated GFR, as calculated by the Cockcroft Gault formula 6 month after kidney transplantation and in the CNIF group was 52.2 +/- 29.3 ml per minute vs 65.36 +/- 21 ml/min in CNI group Tacrolimus/Cyclosporine (p = 0,01).
The short-term result assessing the efficacy of everolimus/MMF(MPA)/steroids regimen are promising and comparable with using CNI protocol but require further observation and research.
To cite this abstract in AMA style:
Stronka M, Adamska Z, Cichanska L, Kubiak J, Gamrat M, Karczewski M. Calcineurin Inhibitor-Free Immunossupresion After Kidney Transplantation, Using Everolimus De Novo – Single Center Experience [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/calcineurin-inhibitor-free-immunossupresion-after-kidney-transplantation-using-everolimus-de-novo-single-center-experience/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress