19 July 2013
Long-term maintenance immunosuppressive regimen with tacrolimus monotherapy
Jean-François AugustoABCDEFG, Jean-François SubraACDEFG, Céline OnnoAEF, Florence VillemainAEF, Anne CroueDE, Corinne DussaussoyE, Jean PicquetE, Brigitte CoefficBE, Johnny SayeghABCDEFDOI: 10.12659/AOT.883979
Ann Transplant 2013; 18:368-377
Abstract
Background
The long-term outcome of kidney transplant recipients on monotherapy with calcineurin inhibitors has been poorly analyzed. This study aimed to describe the long-term outcome of patients on Tac monotherapy (mTac) and to compare this regimen to a standard dual therapy with Tac/MMF.
Material and Methods
This retrospective study included 84 consecutive first kidney recipients transplanted between 1998 and 2003 and followed until 2010. Patients were treated with mTac after the 6th month of transplantation. Survival and incidence of adverse events were analyzed and compared to those of patients treated with Tac/MMF as maintenance regimen after the 6th month of transplantation.
Results
Mean follow-up of the mTac cohort was 8.7±2.2 years. Overall patient and graft survival of the mTac cohort was 91.3% and 86.6%, respectively, at year 8 posttransplant. Tac monotherapy was started in 93.3% of patients at month 6 posttransplant and maintained in 50% of the cohort at the end of the follow-up period. Incidence of acute rejection (AR) and chronic allograft nephropathy (CAN) were 11.9% and 16.6%, respectively. Kaplan-Meyer analysis did not show any difference in patient and graft survival between mTac patients and patients under Tac/MMF. At year 6, compared to Tac/MMF patients, mTac patients had a significantly lower incidence of AR after the 6th month posttransplant and no difference in CAN, cancer, NODAT, and cardiovascular events incidence.
Conclusions
This work suggests that long-term maintenance immunosuppression with mTac is safe in low-immunological risk patients and should be considered for use especially in patients with MMF intolerance.
Keywords: Kidney Transplantation, Tacrolimus, long term follow-up, monotherapy
In Press
08 Mar 2024 : Original article
Association of Coronary Calcium Score on Cardiac PET During Pre-Kidney Transplant Assessment with Persisten...Ann Transplant In Press; DOI: 10.12659/AOT.943532
14 Mar 2024 : Original article
Impact of Blood Products Transfusion on Patients in the Immediate Post-Lung Transplant Period: A Cohort StudyAnn Transplant In Press; DOI: 10.12659/AOT.943652
14 Mar 2024 : Case report
Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo ...Ann Transplant In Press; DOI: 10.12659/AOT.942358
15 Mar 2024 : Review article
Approaches and Challenges in the Current Management of Cytomegalovirus in Transplant Recipients: Highlighti...Ann Transplant In Press; DOI: 10.12659/AOT.941185
Most Viewed Current Articles
05 Apr 2022 : Original article
Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver TransplantationDOI :10.12659/AOT.935604
Ann Transplant 2022; 27:e935604
12 Jan 2022 : Original article
Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...DOI :10.12659/AOT.934738
Ann Transplant 2022; 27:e934738
22 Nov 2022 : Original article
Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...DOI :10.12659/AOT.937988
Ann Transplant 2022; 27:e937988
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860