A pilot study of calcineurin inhibitors (CNIs) and steroid avoidance immunosuppressive protocol among living donor kidney transplant recipients.

Abstract:

:Calcineurin Inhibitors (CNIs) and Corticosteroids have been the main immunosuppressive agents in solid organ transplantation. Many studies have confirmed the positive impacts of withdrawal/avoidance of these agents, separately, on their side effect profiles. A pilot study was performed avoiding both agents among low-immunological-risk living donor kidney transplant recipients at a single center. Seventeen recipients were maintained on the double avoidance protocol during the study period beginning July 2002 through December 2003. Three rejection episodes occurred (out of ten) among related donor kidney recipients and six episodes (out of seven) among unrelated donor kidney recipients. Although most of the rejections were reversed with a short course of corticosteroids, the protocol was revised to exclude the unrelated donor kidney recipients. There were higher incidences of wound complications among recipients who received the initial loading dose of Sirolimus. Double avoidance of CNIs and corticosteroids is possible in living donor kidney transplant recipients with an acceptable incidence of rejection. Proper management of the side effects of Sirolimus could further minimize the incidence of rejection. A multi-center randomized study is recommended in order to recognize the benefits of avoiding CNIs and corticosteroids in renal transplant recipients.

journal_name

Yonsei Med J

journal_title

Yonsei medical journal

authors

Oh HK,Ding P,Satmary NA

doi

10.3349/ymj.2004.45.6.1143

keywords:

subject

Has Abstract

pub_date

2004-12-31 00:00:00

pages

1143-8

issue

6

eissn

0513-5796

issn

1976-2437

pii

2004121143

journal_volume

45

pub_type

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