New immunosuppressive therapies and surgical complications after renal transplantation.

Abstract:

BACKGROUND:To analyze the association between the principal immunosuppressive drugs (mycophenolate mofetil, calcineurin inhibitors and mammalian target of rapamycin [mTOR] inhibitors) used in the routine management of kidney transplant patients and the development of postoperative surgical complications. MATERIALS AND METHODS:We analyzed 415 kidney transplants, studying the influence of various immunosuppressive regimens on the main postoperative surgical complications. RESULTS:The mean follow-up for the entire group was 72.8 months (± 54.2 SD). Patients treated with myeophonolate mofetil (MMF) and cyclosporine (n = 121) experienced a higher frequency of wound eventration odds ratio [OR], 5.2; 95% confidence interval [CI], 1.2-23.5; P = .03) compared with azathioprine and cyclosporine (n = 71). Compared with transplant recipients treated with tacrolimus and MMF (n = 181), transplant recipients treated with cyclosporine and MMF (n = 121) had a significantly greater frequency of wound eventration (OR, 3.7; 95% CI, 1.5-9.5; P = .005), urologic (OR, 2; 95% CI; 1.02-3.9; P = .04), wound (OR; 2.2; 95% CI; 1.07-4.6; P = .03), late (OR, 1.7; 95% CI; 1.01-3.03; P = .04), and Clavien grade 3 surgical complications (OR; 1.9; 95% CI, 1.1-3.37; P = .01). Patients treated with mTOR inhibitors (n = 26) had higher rates of lymphocele (OR, 3.6; 95% CI, (1.1-11.4; P = .002) compared with those who received tacrolimus (n = 197). CONCLUSIONS:New immunosuppressive drugs have improved short-term functional results; however, in some cases they seem to increase surgical complications rates.

journal_name

Transplant Proc

authors

Barba J,Rosell D,Rincon A,Robles JE,Zudaire J,Berian JM,Pascual I,Errasti P

doi

10.1016/j.transproceed.2012.01.112

subject

Has Abstract

pub_date

2012-06-01 00:00:00

pages

1275-80

issue

5

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(12)00308-9

journal_volume

44

pub_type

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