Immunopharmacology and immunotoxicology · 2025
To evaluate the short and long term outcomes of renal transplant recipients with low dose everolimus, tacrolimus-based minimal quadruple immunosuppressive regimen.
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Sailaja K, Rao Ch Umamaheswara, Reddy V S, Rao P Purnachandra, Sahariah S
Аннотация
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.
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.