title: Five years of steroid sparing in renal transplantation with tacrolimus and mycophenolate mofetil.
abstract: Steroid sparing with tacrolimus and mycophenolate mofetil (MMF) is associated with good short-term renal transplant outcomes. However, late allograft dysfunction and failure remain concerns. In this study, 101 consecutive patients underwent renal transplantation with tacrolimus, MMF, and 7 days of corticosteroids only. After a median follow-up of 51 months (range 36-62), overall patient survival is 97%, and overall survival with graft function is 91%. The acute rejection rate at 12 months was 19%. Late rejection was uncommon, with only three further episodes beyond 12 months. Graft function was stable during the study, with a mean creatinine of 140 micromol/L and mean estimated creatinine clearance of 57 ml/min at the end of follow-up. Six patients developed posttransplant diabetes mellitus (three cases beyond 12 months). This steroid avoidance regimen is associated with excellent medium-term patient and graft outcomes, and a low incidence of side effects.
authors.affiliation: Renal and Transplant Units, St. Mary's Hospital, Paddington, London, United Kingdom. richard.borrows@uhb.nhs.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Borrows
authors.forename: Kakit
authors.initials: K
authors.lastname: Chan
authors.forename: Marina
authors.initials: M
authors.lastname: Loucaidou
authors.forename: Christopher
authors.initials: C
authors.lastname: Lawrence
authors.forename: Jen
authors.initials: J
authors.lastname: Van Tromp
authors.forename: Tom
authors.initials: T
authors.lastname: Cairns
authors.forename: Megan
authors.initials: M
authors.lastname: Griffith
authors.forename: Nadey
authors.initials: N
authors.lastname: Hakim
authors.forename: Adam
authors.initials: A
authors.lastname: McLean
authors.forename: Andrew
authors.initials: A
authors.lastname: Palmer
authors.forename: Vassilios
authors.initials: V
authors.lastname: Papalois
authors.forename: David
authors.initials: D
authors.lastname: Taube
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000473:pathology; D003401:Creatine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology; D012307:Risk Factors; D013256:Steroids / Q000494:pharmacology*; D015996:Survival Rate; D016559:Tacrolimus / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids; D009173:Mycophenolic Acid; D003401:Creatine; D016559:Tacrolimus