The combination of sirolimus and cyclosporine does not delay initial renal graft function recovery.
BACKGROUND
Sirolimus has been considered to be a non-nephrotoxic agent. It may delay graft function due to a potential hindrance of the recovery from acute tubular necrosis. It remains controversial as to whether the concomitant administration of sirolimus (SRL) with calcineurin inhibitors delays graft function in Asian patients.


METHODS
This study enrolled 61 patients who received primary renal transplantation. Twenty-one patients aged 38.9 +/- 11 years received early treatment with 6 mg/day sirolimus, 8 mg/kg/day cyclosporine (CsA) and prednisolone (SRL group). Forty patients with a mean age of 36.7 +/- 9 years in the control group were treated with the standard immunosuppressive therapy (8 mg/kg/day CsA, mycophonolate mofetil and prednisolone).


RESULTS
The creatinine level at one week following transplantation in the SRL group was not significantly different from that in the control group (4.7 +/- 1.0 versus 2.7 +/- 0.4 mg/dL, p = 0.17). Similarly, there was no significant difference in the creatinine level at week 2 (3.4 +/- 0.7 versus 2.7 +/- 0.3 mg/dL, p = 0.36), week 3 (2.0 +/- 0.3 versus 2.1 +/- 0.2 mg/dL, p = 0.76), and week 4 (1.8 +/- 0.2 versus 1.8+/-0.1 mg/dL, p = 0.92) between SRL and control groups, respectively. Similarly, the number of the patients with renal function impairment in both groups was not significantly different. The one-year patient and graft survival was 100% and 96%, respectively, in the SRL group and 100% and 98%, respectively, in the control group.


CONCLUSIONS
The combination of sirolimus and cyclosporine did not prolong the recovery from transplantation-associated ischemic injury in kidney graft recipient. Our study demonstrated the safety of early usage of the concomitant administration of sirolimus and cyclosporine in kidney transplantation.
Hsu
Heng Jung
HJ
Department of Nephrology, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Keelung, Taiwan.
Tian
Ya-Chung
YC
Chen
Yung-Chang
YC
Lai
Bien-Chieng
BC
Fang
Ji-Tsuen
JT
Yang
Chih Wei
CW
Wu
Mai-Szu
MS
D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects*; D051799:Delayed Graft Function / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007668:Kidney / Q000187:drug effects; D016030:Kidney Transplantation / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D020123:Sirolimus