Excellent Results of Living-Related Renal Transplant Recipients Treated with High-Dose Mizoribine - Four Year Result -

Abstract

Aim: Mizoribine (MZR) has been developed as an immunosuppressive agent, but has a less potent immunosuppressive effect up to 3 mg/kg/day. In the previous study, therefore, we investigated and reported high-dose MZR, at 6 mg/kg/day, was effective and safe for kidney transplant patients in conjunction with cyclosporine (CsA), basiliximab (BaX) and corticosteroid. In this study, we reported the results of 4 years follow. Method: A total of 40 living related patients aged between 16 and 64 years old,were administered MZR (6 mg/kg/day), CsA (7 mg/kg/day), prednisolone (maintenance dose 5mg/d) and BaX (20 mg/body) between November 2004 and july 2007. A control group (n=38) treated with CsA, mycophenolate mofetil (MMF, 25 mg/kg/day), BaX and corticosteroid was also employed in this study. ABO incompatible and/or cross match positive patients were excluded. Result: Graft survival rates for the MZR and MMF groups were 100% and 94.7% at 1 year after transplantation respectively, 100% and 94.7% at 2 year, 100% and 94.7%at 3 year, and were 92.5% and 94.7% at 4 year, respectively(NS). Serum creatinine levels for the MZR and MMF groups were 1.30 mg/dl and 1.47 mg/dl at 1 year, 1.54 mg/dl and 1.38 mg/dl at 2 year,1.66 mg/dl and 1.41 mg/dl at 3 year, and 1.74 mg/dl and 1.56 mg/dl at 4 year, respectively. There was no significant difference between the two groups in term of serum creatinine. The rejection rate within 6 months in the MZR group (25%) was not significantly higher than that in the MMF group (16%). The number of patients who developed CMV disease was 0(%) in the MZR group and 7 (18.4%) in the MMF group (p< 0.05). The number of patients treated with ganciclovir was 3 (7.5%) and 11 (28.9%) (p< 0.05), respectively. The number of patients treated with allopurinol was 10 (25.0%) of 40 patients in the MZR group and 1 (2.6%) of 38 patients in the MMF group (P< 0.05). There was no significant difference between the two groups in terms of bone marrow suppression or liver dysfunction. Conclusion: The combination of high-dose MZR with CsA, BaX and corticosteroid can establish not only satisfactory immunosuppression but also excellent graft survival.