To evaluate the short and long term outcomes of renal transplant recipients with low dose everolimus, tacrolimus-based minimal quadruple immunosuppressive regimen.
K Sailaja, Ch Umamaheswara Rao, V S Reddy, P Purnachandra Rao, S Sahariah
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引用次数: 0
Abstract
Background: The primary goal of the post-transplant maintenance therapy is to keep equilibrium between minimizing the drug side effects and managing the long-term graft survival. In this prospective (10 years follow-up) study, we compared the short term and long-term outcomes of two different immunosuppression regimens.
Objective: The aim of the study is to evaluate the long term outcome following renal transplantation with a combination of low dose quadruple immunosuppression.
Methods: Group I (n = 25) comprised of low dose everolimus (0.5 mg/bd) (EVR), low dose Tacrolimus (1 mg/bd), low dose mycophenolate sodium (360 mg/bd) and prednisolone. Group II (n = 29) consisted of standard triple drug regimen of tacrolimus (3 mg/bd), mycophenolate sodium (720 mg/bd) and prednisolone. Renal function, rejection episodes, adverse events, graft and patient survival were analyzed.
Results and discussion: There was an improvement in the renal function from 1-year post transplant to the end of the study period in Group I. The mean serum creatinine at 10 years was 1.54 ± 0.44 and in Group II it was 2.1 ± 0.7 mg/dl with a statistical significance of p = 0.005. Mean eGFR at 10 years in Group I was 57.8 and in Group II it was 46.7 ml/mt/1.73m2 (p = < 0.05). There was no statistical difference between the two groups in rejection rates (Group I-12% Group II -17.24% (p = 0.65), graft loss (Group I-12% vs Group II-27%(p = 0.26) and the patient loss was (Group I -12% vs Group II 24%(p = 0.36). Drug related adverse events were insignificant. Proteinuria and hyperlipidemia were comparable between the groups.
Conclusion: The low dose quadruple immunosuppression protocol was a better option for long-term graft survival with fewer complications.
期刊介绍：
The journal Immunopharmacology and Immunotoxicology is devoted to pre-clinical and clinical drug discovery and development targeting the immune system. Research related to the immunoregulatory effects of various compounds, including small-molecule drugs and biologics, on immunocompetent cells and immune responses, as well as the immunotoxicity exerted by xenobiotics and drugs. Only research that describe the mechanisms of specific compounds (not extracts) is of interest to the journal.
The journal will prioritise preclinical and clinical studies on immunotherapy of disorders such as chronic inflammation, allergy, autoimmunity, cancer etc. The effects of small-drugs, vaccines and biologics against central immunological targets as well as cell-based therapy, including dendritic cell therapy, T cell adoptive transfer and stem cell therapy, are topics of particular interest. Publications pointing towards potential new drug targets within the immune system or novel technology for immunopharmacological drug development are also welcome.
With an immunoscience focus on drug development, immunotherapy and toxicology, the journal will cover areas such as infection, allergy, inflammation, tumor immunology, degenerative disorders, immunodeficiencies, neurology, atherosclerosis and more.
Immunopharmacology and Immunotoxicology will accept original manuscripts, brief communications, commentaries, mini-reviews, reviews, clinical trials and clinical cases, on the condition that the results reported are based on original, clinical, or basic research that has not been published elsewhere in any journal in any language (except in abstract form relating to paper communicated to scientific meetings and symposiums).
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