CYCLOSPORINE MONOTHERAPY IN PRIMARY LIVING DONOR RENAL ALLOGRAFT RECIPIENTS

Abstract

231 We have tried cyclosporine monotherapy in primary living donor renal allograft recipients and monitored them prospectively more than 7 years. A total of 120 primary living donor renal allograft recipients were enrolled through randomization on control(n=62) and study (n=58) groups. Immunosuppression was induced 2 days prior to the transplantation using cyclosporine (12mg/kg) and corticosteroids (1 mg/kg). Corticosteroids were tapered down to 0.2 mg/kg during the first month after the transplantation. For the control group, corticosteroids (0.2 mg/kg) was maintained after then. In the study group, corticosteroids tapering was continued until zero at the end of post-transplant month 4. Baseline characteristics of both groups, which could impact on graft survival, were comparable with no statistical difference. Overall patient and graft survival at post-transplant 7 years were 87.8% and 74.2% in control group and 89.2% and 72.4% in study group, respectively (p>0.05). There also was no statistical differences in the frequencies of acute rejection within 1, 6, 12 months and after 1 year post-transplantation between two groups. There were 13 and 16 graft failures during the study period with no statistical difference in control and study groups, respectively. We defined immunosuppressive regimen failure when we had to modify immunosuppressive protocol from whatever reasons. A total of 35 and 34 failures of immunosuppressive regimen were developed in control and study groups, respectively. Graft kidney function was measured by serum creatinine concentration(SCr), which showed no differences between control and study groups. In conclusion, cyclosporine monotherapy should be considered as a possible option in living donor renal allograft recipients when it is combined with careful corticosteroids tapering protocol after immediate post-transplant period (first 4 months).