title: Rationale and criteria of eligibility for calcineurin inhibitor interruption following kidney transplantation.
abstract: OBJECTIVE
  To summarize predictive low-risk parameters of renal allograft recipients for purposes of improving the initiation of calcineurin inhibitor withdrawal protocols.
  
  
  RESULTS
  Clinical trials have demonstrated the potential global benefit of calcineurin inhibitor interruption protocols on graft survival despite being associated with an increased rate of acute rejection episodes, thus underlying a number of risk factors. Recent identification or confirmation of variables updating the list of parameters and molecular markers that can be used to predict graft outcome are described.
  
  
  CONCLUSIONS
  The effect of calcineurin inhibitor withdrawal on long-term graft and recipient survival patterns is assessed in relation to the large number of calcineurin inhibitor-related side-effects. However, current protocols are based on empirical observations and there is a clear requirement for reliable parameters to define patient eligibility for calcineurin inhibitor weaning procedures. Here, we review biological, clinical and genetic parameters that can be used as predictive markers of long-term graft outcome and could serve as criteria for patient selection in calcineurin inhibitor weaning protocols.
authors.affiliation: INSERM U643, Nantes, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Danger
authors.forename: Magali
authors.initials: M
authors.lastname: Giral
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Soulillou
authors.forename: Sophie
authors.initials: S
authors.lastname: Brouard
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D065095:Calcineurin Inhibitors; D004334:Drug Administration Schedule; D020022:Genetic Predisposition to Disease; D006084:Graft Rejection / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007674:Kidney Diseases / Q000139:chemically induced; D016030:Kidney Transplantation; D011110:Polymorphism, Genetic; D018570:Risk Assessment; D012307:Risk Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents