Organ Transplantation Research Today is a free monthly online journal that collates and summarizes the latest research about Organ Transplantation, including details on risks, prognosis, procedure, surgery.

Sequential quadruple immunosuppression including sirolimus in extended criteria and nonheartbeating donor kidney transplantation.

Diekmann F, Campistol JM, Saval N, Gutiérrez-Dalmau A, Arellano EM, Crespo M, Rossich E, Esforzado N, Cofán F, Ricart MJ, Torregrosa JV, Oppenheimer F

Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain.

The aim was to evaluate feasibility and safety of calcineurin inhibitor-free immunosuppression in high-risk donor kidney transplantation with sequential sirolimus introduction. Kidney transplant patients (n=76) with a donor aged >60 years, donor with acute renal failure, or a nonheartbeating donor were included. Immunosuppression consisted of antithymocyte globulin or basiliximab, mycophenolate mofetil, prednisone, and sequential introduction of sirolimus. One-year patient survival was 96.2% and 95.8%; graft survival was 94.2% and 91.7%; acute rejection rates were 21.2% and 12.4%; delayed graft function was 21.2% and 66.7%; and creatinine clearance was 58+/-20 mL/min and 56+/-21 mL/min for the brain-dead donor group and the nonheartbeating donor group, respectively. Most adverse events were infections, but also three lymphoceles, three urinary fistulas, three wound seromas. Sequential sirolimus introduction in high-risk donor kidney transplantation was found to lead to good patient and graft survival and incidence of acute rejection and delayed graft function.

Published 16 August 2007 in Transplantation, 84(3): 429-32.
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