Excellent results with calcineurin inhibitor-free initial immunosuppression in old recipients of old kidneys.
The ever increasing demand for donor organs has forced transplant surgeons to liberalize selection criteria. To avoid initial nephrotoxicity to kidneys from donors over 65 years of age, immunosuppression was begun with an IL-2 receptor antibody, mycophenolate mofetil, and steroids in a total of 38 recipients over 65 years. Calcineurin inhibitors (CI) were added after sufficient graft function was reached. After a mean cold ischemia time of 14:01 hours and a delayed function rate of 31%, patient survival, graft survival, and serum creatinine were 97.4%, 94.7%, and 1.5 mg/dL at 1 and 92.1%, 92.1%, and 1.7 mg/dL at 2 years, respectively. Thus, excellent results can be achieved in old recipients of old donor kidneys with CI-free initial immunosuppression.
Bösmüller
C
C
Department of General and Transplant Surgery, Innsbruck Medical University, Innsbruck, Austria.
Ollinger
R
R
Mark
W
W
Brandacher
G
G
Schneeberger
S
S
Cakar
F
F
Bonatti
H
H
Margreiter
R
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D065095:Calcineurin Inhibitors; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015375:Receptors, Interleukin-2 / Q000276:immunology; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D015375:Receptors, Interleukin-2; D003404:Creatinine; D009173:Mycophenolic Acid