Calcineurin inhibitor-free immunosuppression in renal transplantation.
OBJECTIVE
To describe our initial results using a calcineurin inhibitor-free immunosuppression protocol in renal transplants.


METHODS
Between October 2001 and June 2003, 56 recipients of a renal allografts were started on an immunosuppression protocol without calcineurin inhibitors, consisting of basiliximab, sirolimus, mycophenolate mofetil, and steroids. We analyzed patient and graft survival, acute rejection episodes, and renal function.


RESULTS
The mean follow-up was 19.6 months. Actuarial patient survival at 1 and 2 years was 98.1% and 95.3%, respectively. Actuarial graft survival at 1 and 2 years was 92.9% and 87.6%, respectively. Acute rejection occurred in 27.8% of the patients, usually Banff 1 (73.3%). There was stable renal function with mean serum creatinine of 1.3, 1.4, 1.3, and 1.3 mg/dL at 1, 6, 12, and 24 months after transplant.


CONCLUSIONS
The use of immunosuppression free of calcineurin inhibitors is effective and safe. Further follow-up is needed to evaluate the impact on long-term results.
Parada
B
B
Department of Urology and Renal Transplantation, University Hospital of Coimbra, Coimbra, Portugal. parada.belmiro@netc.pt
Mota
A
A
Nunes
P
P
Macário
F
F
Pratas
J
J
Bastos
C
C
Figueiredo
A
A
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D065095:Calcineurin Inhibitors; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000145:classification / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000145:classification / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018579:Patient Selection; D011446:Prospective Studies; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D020123:Sirolimus / Q000627:therapeutic use*; D013256:Steroids / Q000627:therapeutic use; D014019:Tissue Donors / Q000706:statistics & numerical data
D000911:Antibodies, Monoclonal; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D013256:Steroids; D000077552:Basiliximab; D009173:Mycophenolic Acid; D020123:Sirolimus