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Tacrolimus/mycophenolate mofetil-based immunosuppression in aged kidney transplant. A prospective study
Ricard Solà1, Lluis Guirado, Joan Manuel Díaz
1Kidney Transplant Unit, Fundació Puigvert. C/Cartagena 340, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain. rsola@fundacio-puigvert.es
Background:
At the moment, controversy has arisen about immunosuppression in aged kidney transplant recipients. We present our results on the efficacy and safety of induction treatment based on tacrolimus (FK506) and mycophenolate mofetil (MMF).
Material And Method:
We performed 72 transplants in patients of 60 years or older. Induction treatment consisted on (FK 506) 0.1 mg/kg/day and MMF 2 gr/day. Antilymphocyte serum was administered with delayed graft function. A total of 54 patients received kidneys from donors over 60 years old.
Results:
Cold ischemia time was 16.4 h (S=5.7). Delayed graft function occurred in 35 patients (48.6%). Acute rejection was observed in nine patients (12.5%). Opportunistic infections were found in 19 patients (26.4%). Seven patients died due to sudden death (1), acute myocardial infarction (1), stroke (1), infection (3), and neoplasm (1). At 1, 2, and 3 years, serum creatinine was 145, 163, and 156 mmol/l; patient survival 93%, 90%, and 90%; graft survival 93%, 90%, and 87%; and death-censored graft survival 100%, 100%, and 97%, respectively.
Conclusion:
These immunosuppressive guidelines appear to be efficacious and safe in kidney transplant in elderly recipients.