Resumen

Introduction: Kidney transplant recipients who share 2 haplotypes (KTR-2 HP) with their donors have low immunologic risk, for this reason they often use a double immunosuppressive scheme (ISS), which excludes calcineurin inhibitors. This study compares the long-term outcomes of a double ISS vs. triple ISS in KTR-2 HP. Material and methods: Retrolective, comparative cohort study. Two groups were formed: 1) KTR-2 HP who received double ISS, and 2) KTR-2 HP with triple ISS. The outcomes evaluated were: renal function, acute rejections, graft loss, death, infections, hospitalizations, changes in ISS and the cause for change. Results: 85 KTR-2 HP were analyzed, 60 in group 1 and 25 in group 2. Median of follow up was 138 months (23-203) and 55 months (12-106) in group 1 and 2, respectively. There were 4 episodes of acute rejection and 9 graft losses, both outcomes occurred only in patients from group 1. There was no difference in graft survival or renal function at 60 months between both groups. The ISS was changed in 23 patients, 12 (53%) from group 1 and 11 (47%) from group 2. The main cause for ISS change in group 1 was azathioprine associated leucopenia in 5 patients, and in group 2 cyclosporine nephrotoxicity in 6 patients. Conclusions: Regardless of their evident nephrotoxicity, the use of a calcineurin inhibitor offers advantages even in this group of low immunologic risk patients.

Palabras clave: Kidney transplant 2-haplotypes calcineurin inhibitor double immunosuppressive scheme immunologic risk.

2010-10-07   |   877 visitas   |   Evalua este artículo 0 valoraciones

Vol. 62 Núm.3. Mayo-Junio 2010 Pags. 200-205 Rev Invest Clin 2010; 62(3-ENGLISH)