Tacrolimus monotherapy in renal transplantation: four-year data

Abstract

Forty-five primary allograft recipients were approached. Fifteen patients were excluded from the study for one or more of the following reasons: pregnancy or nursing mother, allergy or intolerance to steroids or tacrolimus, panel reactive antibodies greater than 50%, other organ transplant or investigational drug, delayed graft function, or acute tubular necrosis. Thirty patients were subsequently recruited into the study, 25 males and five females, with a mean age of 43 years. The mean number of HLA mismatches was 1.82, with no more than three in total, and no more than one at DR. 85% of patients had no mismatch at DR. The target trough level of tacrolimus during the first month was 10 to 20 ng/mL with a target maintenance level of 10 ng/mL. The fourth anniversary of the study has been reached, and 21 patients (70%) remain on (and have only ever received) tacrolimus monotherapy as immunosuppression, except for the transient use of intravenous methylprednisolone for the treatment of acute rejection. We have reevaluated the progress of the group. The clinical and biochemical data were abstracted from the clinical records.