Sirolimus-based triple immunosupression with antithymocyte globulin induction in expanded criteria donor kidney transplantation

Nephrology
Adam UsluTamer Sahin

Abstract

Target of rapamycin inhibitors have presented similar graft and patient outcomes with no evidence of drug-induced nephrotoxicity when compared with calcineurin inhibitors. The principal aim of this study is to demonstrate the efficacy of sirolimus-based triple immunosuppression with antithymocyte globulin induction in expanded donor kidney transplantation. Twenty-seven primary expanded criteria donor kidney transplant recipients were recruited. The severity of kidney damage was qualified by zero-hour biopsies. Protocol biopsies were performed at 1 year to assess the chronic allograft damage. Death, graft function, proteinuria and adverse events were systematically analysed during the study period. The mean follow up was 20.2 months. Patient and graft survival was 100% with a mean glomerular filtration rate (GFR) of 53.1+/-4.9 mL/min at last follow up. The cumulative incidence of acute rejection was 11% at the last follow up. At 1 year, mean creatinine, GFR and proteinuria were 1.84 mg/dL, 52.3 mL/min, 651.5 mg/day, respectively. Four patients required surgical intervention due to urinary complications and recovered successfully. Two patients developed acute graft dysfunction due to acute tubular necrosis which was presumably dr...Continue Reading

References

Jun 27, 1995·Transplantation·B J NankivellJ R Chapman
Mar 4, 2000·The New England Journal of Medicine·S HariharanD Stablein
Dec 12, 2003·The New England Journal of Medicine·Brian J NankivellJeremy R Chapman
Oct 13, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Stuart M FlechnerDaniel R Salomon
Dec 8, 2004·Journal of the American Society of Nephrology : JASN·Bruce Kaplan, Herwig-Ulf Meier-Kriesche
Jan 10, 2006·Seminars in Dialysis·Akinlolu O Ojo
Feb 14, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·T S LarsonJ A Velosa

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Citations

Mar 25, 2016·World Journal of Transplantation·Vassilis Filiopoulos, John N Boletis

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