Safety and efficacy of TOR inhibitors and other immunosuppressive regimens in African-American renal transplant recipients.
African-American renal transplant recipients have higher rates of acute allograft rejection and lower rates of allograft survival compared with Caucasian patients, and these differences have not been eliminated by a new generation of potent immunosuppressive drugs. In particular, African-Americans tend to exhibit higher rejection rates after withdrawal of corticosteroid therapy. Based on promising early results using the combination of sirolimus and low-dose tacrolimus in liver, kidney-pancreas, and islet-cell transplant recipients, our center is conducting a pilot study of this immunosuppression regimen in African-American patients. As of April 2001, there has been only 1 acute rejection episode (2.8%) in this cohort. Long-term follow-up of these patients will be necessary to assess the benefits and risks of this regimen.
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Division of Nephrology, Case Western Reserve University School of Medicine, Cleveland, OH, USA. deh5@po.cwru.edu
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D044383:Black People / Q000235:genetics*; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000453:epidemiology / Q000276:immunology*; D006085:Graft Survival / Q000187:drug effects* / Q000235:genetics / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D010597:Pharmacogenetics; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use*; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome; D001741:Black or African American
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus