In the last decade, elderly patients (≥60y) have been more frequently listed for renal transplantation. From 2007 to 2014 the percentage of elderly renal transplant recipients increased from 11% to 21%, at our center. Elderly recipients are more prone to develop diabetes, Infection, cardio-vascular disease and cancer. The nEverOld trial is an ongoing, single center, prospective randomized trial, comparing conversion to low TAC/Everolimus (EVL) at 1^st month with TAC/enteric coated – sodium mycophenolate (EC-MPS) in elderly renal transplant recipients (≥60y). All received induction therapy with ATG (single dose of 2mg/kg). Patients received oral valGCV prohylaxis up to 90 days that was withdrawn when EVL started. So far, 72 (80% of total) patients with a mean age of 65±4 (60-78) years, have been enrolled:39 in the lowTAC/EVL arm and 33 in the TAC/EM-MPS arm. Demographics and RTx features were very similar.TAC trough levels were lower (p<0.046) in the EVL arm at 3, 6 and 12 months, as per protocol. At the mean f-up of 425±352 days patient survival (76±8vs77±9%) death-censored graft survival (92±4vs90±7%) and eGFR(MDRD4) (48±19vs47±16ml/min/1.73m2) did not differ for EVL and MPS arm, respectively. 6/10 patients died before conversion In the EVL arm and 4/6 (before day 30), in the MPS arm. 50% due to infection. Although not statistically significant, there were 2 cancers, 2 BK nephropathy and 3 CMV disease in group MPA but only 1 CMV and less patients re-admitted to the hospital in the EVL arm less.

These data show that, so far, the EVL arm has the same efficacy but seems to have a better safety profile in elderly recipients.

CITATION INFORMATION: David-Neto E, Agena F, Ramos F, Triboni A, Altona M, Coelho V, Galante N, Lemos F. Everolimus/Low Tacrolimus(TAC) Compared to MPA/RegularTAC for Renal Transplantation in the Elderly Recipient – Preliminary Analysis of the nEverOld Trial. Am J Transplant. 2016;16 (suppl 3).

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