Outcomes of Hispanic Kidney Transplant Recipients Under a Cyclosporine Versus Tacrolimus Based Immunosuppression Regimen
1Surgery, University of Illinois, Chicago
2Pharmacy Practice, University of Illinois, Chicago.
Meeting: 2015 American Transplant Congress
Abstract number: D135
Keywords: Calcineurin, Graft function, Hispanic, Infection
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
Purpose: In 2005, an internal retrospective study at our institution showed a higher incidence of post transplant diabetes mellitus (PTDM) in our Hispanic kidney transplant recipients on tacrolimus (TAC)/prednisone regimen. Around this same time, we implemented a steroid avoidance program and changed our maintenance immunosuppression to a cyclosporine (CSA) based regimen in a subset of our Hispanic recipients. The objective of this study was to compare the renal function, acute rejection, graft and patient survival at 1, 3, and 5 years post transplant in Hispanic kidney transplant recipients who received CSA versus TAC. Additionally, we assessed the incidence of PTDM, CMV viremia, and BK viremia in this population.
Methods: This was a retrospective review of electronic medical records of all adult Hispanic patients that received a renal transplant from January 2004 to December 2009.
Results: We identified 169 Hispanic kidney transplant recipients for our cohort of which 84 were in the TAC group and 61 were in the CSA group. The remaining 22 patients were on an mTOR inhibitor and were not included in this analyses. More TAC patients received anti-thymocyte globulin and more CSA patients received basiliximab/daclizumab. Greater than 90% of patients were on a steroid avoidance/calcineurin inhibitor/mycophenolic acid regimen. The glomerular filtration rate and graft and patient survival at 1, 3, and 5 years post transplant were similar between the two groups. The incidence of acute rejection was 15.6% in the TAC group compared to 11.7% in the CSA group in the first-year post transplant. The incidence of PTDM in the first year was 15.4% in the TAC group and 13.33% in the CSA group. The incidence of BKV was 33.7% in the TAC group and 24.6 in the CSA group. However, the incidence of CMV viremia was 24.1% in the TAC group and 6.56% in the CSA group (p=0.0053).
Conclusion: There was no difference in renal function, acute rejection rates, and patient and graft survival in our Hispanic kidney recipients on a TAC based regimen compared to a CSA based regimen. There was also no difference in the incidence of PTDM or BKV between the 2 groups. However, there was a significant increase in the incidence of CMV viremia in the TAC group.
To cite this abstract in AMA style:
West-Thielke P, Campara M, Ladik A, Terranova E, Benedetti E, Thielke J. Outcomes of Hispanic Kidney Transplant Recipients Under a Cyclosporine Versus Tacrolimus Based Immunosuppression Regimen [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-hispanic-kidney-transplant-recipients-under-a-cyclosporine-versus-tacrolimus-based-immunosuppression-regimen/. Accessed November 23, 2024.« Back to 2015 American Transplant Congress