Short-term results under three different immunosuppressive regimens at one center.
We examined short-term outcomes and posttransplant medical complications under three different immunosuppressive regimens at a single center. The study design was a randomized, prospective, open-label trial comparing a calcineurin inhibitor-free (CNI) protocol to standard triple therapy with tacrolimus, prednisone, and mycophenolate mofetil. They were also compared to a concurrent but nonrandomized third cohort treated with a prednisone-free protocol. All three groups had excellent early outcomes with no significant difference in patient or graft survival or biopsy-proven acute rejection. Serum creatinine was significantly lower in the CNI-free recipients. Lipid panels and posttransplant diabetes mellitus were significantly lower in the prednisone-free patients. Prednisone-free kidney transplant recipients have improved early glucose metabolism and hyperlipidemia compared to CNI-free or standard triple therapy recipients with comparable rejection and graft survival rates.
Schaefer
H M
HM
Division of Kidney and Pancreas Transplantation, Vanderbilt University Medical Center, Nashville, Tennessee 37232-4750, USA.
Kizilisik
A Tarik
AT
Feurer
I
I
Nylander
W A
WA
Langone
A J
AJ
Helderman
J H
JH
Shaffer
D
D
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001706:Biopsy; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000453:epidemiology / Q000473:pathology; D006085:Graft Survival / Q000502:physiology; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology* / Q000401:mortality; D019520:Living Donors; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D020123:Sirolimus / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D003404:Creatinine; D009173:Mycophenolic Acid; D011241:Prednisone; D020123:Sirolimus; D008775:Methylprednisolone