Abstract presented at American Transplant Congress, May 2005, Seattle, WA.
Long-Term Renal Allograft Function on a Tacrolimus-Based, Pred-Free Maintenance Immunosuppression Comparing Sirolimus vs. MMF†
Article first published online: 13 APR 2006
American Journal of Transplantation
Volume 6, Issue 7, pages 1617–1623, July 2006
How to Cite
Gallon, L., Perico, N., Dimitrov, B. D., Winoto, J., Remuzzi, G., Leventhal, J., Gaspari, F. and Kaufman, D. (2006), Long-Term Renal Allograft Function on a Tacrolimus-Based, Pred-Free Maintenance Immunosuppression Comparing Sirolimus vs. MMF. American Journal of Transplantation, 6: 1617–1623. doi: 10.1111/j.1600-6143.2006.01340.x
- Issue published online: 13 APR 2006
- Article first published online: 13 APR 2006
- Received 19 August 2005, revised 13 February 2006 and accepted for publication 27 February 2006
- Graft function;
- graft survival;
- kidney transplantation;
It is not known how different steroid-free immunosuppressive combinations affect renal graft survival and long-term kidney transplant function. Here we sought to compare the impact on graft survival and long-term graft function of two tacrolimus (Tac)-based, prednisone-free maintenance immunosuppressive protocols: Tac/Mycophenolate Mofetil (MMF) vs. Tac/Sirolimus (SRL). Renal transplant patients given induction therapy with IL2-RA and methylprednisolone on days 0, 1 and 2 post-transplant were prospectively randomized to two maintenance immunosuppressive regimens with Tac/MMF (n = 45) or Tac/SRL (n = 37). During the 3-year follow-up the following data were collected: patient survival, renal allograft survival, incidence of acute rejection and glomerular filtration rate (GFR) at different time-points post-transplant. Cumulative graft survival was significantly different in the two groups: one kidney loss in the Tac/MMF vs. six kidney losses in the Tac/SRL (log-rank test p = 0.04). GFR at different time-points post-transplant was consistently and statistically better in the Tac/MMF than in the Tac/SRL group. The slope of GFR decline per month was flatter in the Tac/MMF than in the Tac/SRL group. This study showed that renal graft survival and graft function were significantly lower in the combination of Tac/SRL than Tac/MMF.