Efficacy and safety of initial-dose mizoribine plus tacrolimus and corticosteroids in living-related renal transplant recipients

Objective To assess the efficacy and safety of mizoribine (MZR) in initial immunosuppression in living-related renal transplant recipients. Methods From October 2015 to October 2017, twenty-two patients undergoing initial living-related renal transplantation received MZR (3-4 mg/kg/d) plus tacrolimus and corticosteroid. During a follow-up period of 12 months, patient/graft survival, incidence of acute rejection and adverse events were observed. Results There was no onset of graft loss and death and acute rejection rate was 22.7%. Renal allograft function remained stable. The incidence rate of cytomegaloviral infection was 4.5% and no CMV disease occurred. The incidence of BKV viruria was 36.4% and the infection rate was 18.2%. Digestive symptoms occurred (n=3, 13.6%). The major side effect of hyperuricemia could be controlled without reduction or withdrawal of MZR. Conclusions Excellent graft survival can be achieved when using MZR as initial immunosuppression in living-donor renal transplant recipients, yet the incidence of acute rejection remains high. Further study is required for determining the effect of MZR in the prevention of BK viral infection during renal transplantation. Key words: Kidney transplantation; Mizoribine; Acute rejection