Sirolimus-based, calcineurin-inhibitor sparing immunotherapy, long-term (6-year) results

At the Albany Medical Center, we have a long-term experience, mean follow-up of 75 months, in 50 renal transplant recipients treated with maintenance sirolimus, prednisone and a calcineurin-inhibitor sparing immunosuppressive regimen. One-year patient and graft survival was 98% and six-year patient and graft survival was 82% and 72% respectively. The rate of early acute rejection (<3 months) was only 10%. Furthermore, no late (>3 months) acute rejection episodes developed despite calcineurin-inhibitor dose minimization. In addition, recipient mean serum creatinine remained stable at 1.6 mg/dl throughout the 6-year follow-up period. Sirolimus is an effective maintenance immunosuppressive agent that safely allows for a reduction in calcineurin-inhibitor dosing.