Reduced Incidence of Cytomegalovirus Infection in Kidney Transplant Recipients Receiving Everolimus
1Nephrology, Hospital do Rim UNIFESP, Sao Paulo, Brazil
2Urology, Hospital do Rim UNIFESP, Sao Paulo, Brazil
3Pathology, UNIFESP, Sao Paulo, Brazil
4Immunogenetic, AFIP, Sao Paulo, Brazil.
Meeting: 2015 American Transplant Congress
Abstract number: 212
Keywords: Antilymphocyte antibodies, Cytomeglovirus, Immunosuppression, Kidney transplantation
Session Information
Session Name: Concurrent Session: Kidney: Immunosupression Minimization
Session Type: Concurrent Session
Date: Monday, May 4, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 3:27pm-3:39pm
Location: Room 113-BC
BACKGROUND: CMV infection is associated with inferior long-term kidney transplant outcomes. This study compared the incidence of CMV infection/disease in de novo kidney transplant recipients receiving three immunosuppressive regimens and no CMV pharmacological prophylaxis.
METHODS: We randomized and treated (1:1:1) 288 low/moderate kidney transplant recipients to receive a single 3 mg/kg dose of rabbit antithymocyte globulin, tacrolimus, everolimus and prednisone (r-ATG/EVR, n=85), basiliximab, tacrolimus, everolimus and prednisone (BAS/EVR, n=102) or basiliximab, tacrolimus, mycophenolate and prednisone (BAS/MPS, n=101). The primary end-point was the cumulative incidence of first CMV infection/disease in the intention to treat population. Secondary end-points included biopsy confirmed acute rejection, graft loss, death, renal function and safety.
RESULTS: Patients receiving EVR showed lower incidence of CMV infection/disease compared to those receiving MPS (4.7 vs. 10.8 vs. 37.6%, p<0.001). There were no differences in the incidence of first treated biopsy confirmed acute rejection (9.4 vs. 18.6 vs. 15.8%, p=0.403), patient (96.5 vs. 95.1 vs. 96%, p=0.893) and graft (95.3 vs. 93.1 vs. 89.1%, p=0.267) survivals. There were no differences in the incidence of wound-healing complications (23.5 vs. 34.3 vs. 22.8%, p=0.123) and delayed graft function (47 vs. 48.5 vs. 41.5%, p=0.701). Mean estimated glomerular filtration rate was lower in BAS/EVR (65.7±21.8 vs. 60.6±20.9 vs. 69.5±21.5 ml/min, p=0.021) respectively, but no differences in proteinuria was observed.
CONCLUSION: In de novo kidney transplant recipients receiving TAC-based immunosuppressive regimen and no pharmacological CMV prophylaxis, the use of everolimus was associated with a significant reduction in the incidence of CMV infection/disease compared to mycophenolate.
To cite this abstract in AMA style:
Tedesco-Silva H, Felipe C, Ferreira A, Cristelli M, Freitas TSandes-, Oliveira N, Aguiar W, Bassos G, Franco M, Lima MGerbase-, Campos E, Medina-Pestana J. Reduced Incidence of Cytomegalovirus Infection in Kidney Transplant Recipients Receiving Everolimus [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/reduced-incidence-of-cytomegalovirus-infection-in-kidney-transplant-recipients-receiving-everolimus/. Accessed October 3, 2024.« Back to 2015 American Transplant Congress