title: [Immunosuppression for living donor renal allograft recipients].
abstract: Living donor kidney transplantation allows immunosuppression individualization based on clinical and immunological criteria. Living donor kidney transplantation allows administration of immunosuppressive drugs days before transplantation, for a better acute rejection prevention. A 3-day course of tacrolimus and a micophenolic acid derivative is recommended. In recipients HLA-identical related to the donor, a tacrolimus-micophenolic acid r&eacute;gimen is recommended. Tacrolimus withdrawal after 6 months may be advisable. In all non-HLA-identical recipients, basiliximab induction is recommended, with the exception of high immunological risk patients, in whom thymoglobulin is a better option. The use of a kidney from an expanded criteria donor might imply a reduction in tacrolimus exposure since the very beginning, to optimize kidney graft function. In general, and depending on immunological risk, steroid withdrawal after the first 3 to 6 months is recommended. ABO-incompatible living donor kidney transplantation is feasible after specific immunoadsorption, gammaglobulins, a dose of rituximab and conventional immunosupression.
authors.affiliation: Servico de Nefrologia, Hospital del mar de Salut Mar. Barcelona. julpascual@gmail.com
authors.forename: Julio
authors.initials: J
authors.lastname: Pascual Santos
authors.forename: Domingo
authors.initials: D
authors.lastname: Hernández Marrero
mesh_terms: D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000276:immunology; D019520:Living Donors