Induction Immunosuppressive Therapy With Everolimus and Low-Dose Tacrolimus Extended-Release Preserves Good Renal Function at 1 Year After Kidney Transplantation

被引：4

作者：

Yamanaka, K. ^{[1
]}

Kakuta, Y. ^{[1
]}

Nakazawa, S. ^{[1
]}

Kato, T. ^{[1
]}

Abe, T. ^{[1
]}

Imamura, R. ^{[1
]}

Okumi, M. ^{[2
]}

Ichimaru, N. ^{[3
]}

Kyo, M. ^{[4
]}

Kyakuno, M. ^{[5
]}

Takahara, S. ^{[3
]}

Nonomura, N. ^{[1
]}

机构：

[1] Osaka Univ, Grad Sch Med, Dept Urol, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan

[2] Tokyo Womens Med Univ, Dept Urol, Tokyo, Japan

[3] Osaka Univ, Grad Sch Med, Dept Adv Technol Transplantat, Osaka, Japan

[4] Sakurabashi Iseikai Clin, Osaka, Japan

[5] Takatsuki Gen Hosp, Dept Renal Transplantat, Osaka, Japan

来源：

TRANSPLANTATION PROCEEDINGS | 2016年 / 48卷 / 03期

关键词：

CALCINEURIN INHIBITORS; ACUTE REJECTION; ALLOGRAFT SURVIVAL; REDUCED-EXPOSURE; HLA ANTIBODIES; FOLLOW-UP; CYCLOSPORINE; MULTICENTER; EVENTS;

D O I：

10.1016/j.transproceed.2015.12.077

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Utilization of everolimus (EVR) has been increasing in recent years for patients undergoing renal transplantation to reduce calcineurin inhibitor (CNI) levels. However, an optimum regimen has yet to be established. Methods. We retrospectively examined 12 renal transplant recipients who underwent an induction immunosuppressive protocol; the protocol comprises 5 agents, including EVR plus low-dose tacrolimus extended-release (TAC-ER) treatment. We compared those findings from those of 14 patients who underwent a conventional protocol without EVR. Clinical outcome and pathologic changes were assessed by using protocol graft biopsy findings obtained at 3 months and 1 year after transplantation. Results. The estimated glomerular filtration rate was significantly higher for the EVR group at both 3 months and 1 year compared with the conventional group (P < .01 and P = .03, respectively). TAC-ER trough levels were also significantly lower at 3 months and 1 year (both, P < .01). Histologic findings of the 3-month protocol biopsy samples in the EVR group revealed 4 cases of borderline change and 2 of acute cellular-mediated rejection. The findings from the 1-year biopsy samples revealed 10 cases with normal findings with no evidence of CNI toxicity. Patients in the EVR group developed subclinical borderline change and acute cellular-mediated rejection after 3 months at a significantly higher rate than the conventional group (P = .02). Conclusions. Use of the present therapeutic strategy successfully maintained the trough of each drug at a lower level, and it also kept renal function stable up to 1 year after transplantation.

引用

页码：781 / 785

页数：5

共 24 条

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