Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose: Long-term efficacy and safety of everolimus (EVR) based immunosuppression for de novo kidney transplant recipient who were involved in A1202 study was evaluated in clinical outcomes as well as biopsies findings and donor specific antibody (DSA) production.
Methods: During March 2008 and August 2009, twenty-four recipients prospectively randomized into two groups to compare clinical outcome of kidney transplantation between EVR based and MMF based immunosuppression with basiliximab induction with steroid. EVR group received reduced-exposure CsA (C0 25-50ng/ml after 6 months) and EVR-C0 were adjusted 3-12ng/ml. MMF group received standard-exposure CsA (C0 100-250ng/ml after 6 months) .
Results: With a mean observationof 9.0 (8.2-9.6) years, current patient survival is 100% in both group and graft survival is 100% in EVR group and 90.9% in MMF group (EVR; n=13, MMF; n=11). All patients are staying on primary protocol in EVR group but 3 patients (27.3%) were converted to tacrolimus. Calcurated eGFR was similar 39.9±14.9 in EVR group and 33.6±9.7 in MMF group. Significant proteinuria, more than 300mg/day, were observed more in EVR group (77%) than in MMF group (54.5%) respectively. Incidence of Cytomegalovirus (CMV) infection was significantly reduced to 15.1% in EVR group comparing to 46.2% in MMF group, especially none of seropositive recipients for CMV developed CMV infection. None of EVR and 9.1% of MMF group was treated for clinical T cell mediated rejection, similar incidence of Banff borderline change on protocol biopsies were observed in 7.7% of EVR group and 18.2% of MMF group. None of EVR group revealed peritubular capillaritis while 9.1% in MMF group developed chronic active antibody mediated rejection. Luminex solid phase assay revealed accumulative class II DSA production rate of 15.4% in EVR group and 18.3% in MMF at 9 years after transplantation respectively.
Conclusions: EVR based immunosuppression provides equivalent or even better clinical outcomes as well as the incidence of de novo DSA production with MMF based immunosuppression with 9 years follow-up.
CITATION INFORMATION: Narumi S., Watarai Y., Goto N., Hiramitsu T., Okada M., Tsujita M., Futamura K., Nishihira M., Kobayashi T. Long-Term Efficacy and Safety of Everolimus Based Immunosuppression on De Novo Kidney Transplantation with 9 Years Follow-Up Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Narumi S, Watarai Y, Goto N, Hiramitsu T, Okada M, Tsujita M, Futamura K, Nishihira M, Kobayashi T. Long-Term Efficacy and Safety of Everolimus Based Immunosuppression on De Novo Kidney Transplantation with 9 Years Follow-Up [abstract]. https://atcmeetingabstracts.com/abstract/long-term-efficacy-and-safety-of-everolimus-based-immunosuppression-on-de-novo-kidney-transplantation-with-9-years-follow-up/. Accessed August 8, 2020.
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