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Presenter: Hoda, Mamoun, cairo, Egypt
Authors: Soliman A., Mamoun H., Zayed B.
CLINICAL IMMUNOSUPPRESSION - KIDNEY LATE
A.R. Soliman1, H. Mamoun2, B. Zayed2
1Internal Medicine, cairo university, cairo/EGYPT, 2Nephrology, Cairo University, Cairo/EGYPT
Body: Introduction: Reducing calcineurin-inhibitor induced nephrotoxicity and simultaneously avoiding long-term side effects is a desirable goal in renal transplantation. Methods: We examined the hypothesis that using cyclosporin A and mycophenolate mofetil (MMF) 48 hours before renal transplantation would allow lowering the target cyclosporin C2 concentration and have decreasing toxicity and improving graft function. Eighty kidney recipients were enrolled in a single center study comparing two cyclosporin A-based protocols. Group I (n=40) patients received a standard dose cyclosporin (blood cyclosporin C2: 800-1500 ng/ml) with MMF and a standard dose corticosteroid. Group II(n=40)patients were treated with a low-dose cyclosporin (blood cyclosporin C2 concentration 450-800 ng/ml) and MMF, a low dose corticosteroid and induction with cyclosporin A and MMF 48 hours before surgery. Results: Patient (97.5% versus 100%) and graft survival (92.5 versus 95%) at 1 year were not different between groups. Patients of group II experienced significantly less acute rejections than group I (10% versus 30%, p<0.01). Delayed graft function occurred less often in group I than group II but the difference is not significant (17.5 versus 20%, p=NS. Graft function at 1 year was significantly better in group II (serum creatinine 1.31 versus 1.64 mg/dl and creatinine clearance 63 ml/min versus 47 ml/min, p<0.05).Conclusion: We can conclude that a regimen consisting of cyclosporin A and MMF 48 hours before surgery allows safe and efficient use of low target C2 concentration and enable early decrease of cyclosporin dose. These preliminary results indicate a better 1 year graft function compared to a normal dose cyclosporin A regimen.
Disclosure: All authors have declared no conflicts of interest.
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