Delayed renal graft function: the influence of immunosuppression.

Abstract

INTRODUCTION:

We evaluated the influence of different immunosuppressive regimens on delayed renal graft function and progression of renal function in the first year after transplantation.

PATIENTS AND METHODS:

Patients were divided into four groups according to the immunosuppressive regimen received: (1) rapamycin (Rap) + mycophenolate mofetil (MMF) + methylprednisolone (MP) + daclizumab (Dmab); (n = 44); (2) tacrolimus (Tac) + MMF + MP + Dmab (n = 39); (3) cyclosporine (CsA) + MMF + MP + basiliximab (Bmab); (n = 30); (4) antithymocyte globulin (ATG) + MMF + MP and CsA after ATG withdrawal (n = 40). Data were analyzed using ANOVA and linear regression. Delayed graft function was defined as the need for hemodialysis posttransplantation.

RESULTS:

There were no statistically significant differences between the four groups in terms of gender, time on dialysis before transplantation, histocompatibility, donor age, and cold ischemia time. However, age (49.8, 50.4, 49.8, and 43.5 years, P < .05), panel reactive antibodies (22%, 39%, 27%, 34%, P < .05) and time of delayed graft function (12, 7, 3, 6 days, P < .05) were significantly different between the four groups. The time of delayed graft function depended on the immunosuppressive regimen, as well as donor and recipient age (P < .05). The creatinine clearance demonstrated a statistically significant difference between the four groups in the first month after transplantation (45, 46, 61, 53 mL/min, P < .05), though no further difference was observed at the month 12th.

CONCLUSIONS:

The type of immunosuppressive therapy seems to substantially influence the time of recovery from delayed renal graft function, even though it does not seem to affect future graft function. Especially Rap, probably due to its potent antiproliferative effects, seems to prolong the length of graft recovery after renal transplantation.

• Authors: J Boletis, A Balitsari, V Filiopoulos, E Stamataki, S Lionaki, G Zavos, A Kostakis
• Journal: Transplantation proceedings (Transplant Proc) Vol. 37 Issue 5 Pg. 2054-9 (Jun 2005) ISSN: 0041-1345 [Print] United States
• PMID: 15964337 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antilymphocyte Serum
• Immunoglobulin G
• Immunosuppressive Agents
• Daclizumab
• Mycophenolic Acid
• Sirolimus
• Tacrolimus
• Methylprednisolone

Topics

• Adolescent
• Adult
• Analysis of Variance
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Antilymphocyte Serum (therapeutic use)
• Cadaver
• Daclizumab
• Female
• Humans
• Immunoglobulin G (therapeutic use)
• Immunosuppression Therapy (methods)
• Immunosuppressive Agents (therapeutic use)
• Kidney Transplantation (immunology, physiology)
• Male
• Methylprednisolone (therapeutic use)
• Middle Aged
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Regression Analysis
• Retrospective Studies
• Sirolimus (therapeutic use)
• Tacrolimus (therapeutic use)
• Tissue Donors