Date: Monday, June 13, 2016
Session Time: 4:30pm-6:00pm
Presentation Time: 5:30pm-5:42pm
Location: Ballroom A
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 1st 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 Patients received oral valGCV prohylaxis up to 90 days that was withdrawn when EVL started.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.
| EVL/Low TAC
|Deaths (before conversion or Day 30)||10 (6)||6 (4)|
|Graft loss|| 3 all before convertion to EVL
(2 arterial thrombosis, 1 never functioning graft)
(2 BKV nephopathy)
|IS change|| 3
(2 proteinuria, 1 mTORi pneumopathy)
(2 diarrhea, 2 BKV nephropathy)
|Acute Rejection||9 (23%)||6 (18%)|
(1 GI tract, 1 lymphoproliferative)
|DM pre/post tx||14/2||19/3|
|Number of pts without hospitalization||21 (54%)||14 (42%)|
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).
To cite this abstract in AMA style: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. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/everolimuslow-tacrolimustac-compared-to-mparegulartac-for-renal-transplantation-in-the-elderly-recipient-preliminary-analysis-of-the-neverold-trial/. Accessed March 4, 2021.
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