Background Calcineurin inhibitor(CNI) nephrotoxicity is one of the major reasons for chronic allograft injury in live kidney transplantation from old donors to young recipients. Therefore we carry out a retrospective cohort study with the aim to evaluating whether calcineurin inhibitors transferring to rapamycin on 3 months after live kidney transplantation from old donors to young recipients could improve the long-term kidney allograft function.

Methods We retrospectively collected 308 cases of live kidney transplantation with young recipients(age <30 years old) and old donors(age>50 years old) from January 2005 to November 2015. Among these recipients, 92 recipients transferred from CNI to rapamycin(Rapa group) on 3 months after kidney transplant, who was matched with 92 recipients who persisted on CNI(CNI group) according to the age and gender of donors and recipients. The 1 year graft function, long-term graft and patient survival, and complications after 3 months were compared between the two groups.

Results The acute rejection rate was comparable between Rapa group and CNI group(17.4% vs. 15.2%, p=0.690). However, incidence of chronic allograft injury was significantly lower in Rapa group compared to CNI group(13.0% vs. 25.0%, p=0.039). the 1-year serum creatinine level was significantly lower in Rapa group (114.7±48.2 vs.131.5±55.4umol/L, p=0.029). The new onset diabetes rate was higher in CNI group(10.9% vs. 3.3 %,p=0.044). The incidence of hyperlipemia was significantly higher in Rapa group(23.9% vs.9.8%, p=0.01). The incidences of proteinuria, liver function impairment, infection, cerebral vascular diseases were all comparable between the two groups(p>0.05). The 1-,3-,5- year graft and patient survival were also comparable between the two groups(p>0.05).

Conclusion Calcineurin inhibitors transferring to rapamycin can reduce chronic allograft injury and improve graft function in live donor kidney transplantation from old donors to young recipients.

CITATION INFORMATION: Chen G, Wang C, Wu Z, Wang C, Qiu J, Chen L. Efficacy of Calcineurin Inhibitors Transferring to Rapamycin in Live Kidney Transplantation from Old Donors to Young Recipients. Am J Transplant. 2017;17 (suppl 3).

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