Kidney transplant histology after one year of continuous therapy with sirolimus compared with tacrolimus

Patrick G. Dean, Joseph P. Grande, Sanjeev Sethi, Walter D. Park, Matthew D. Griffin, Fernando G. Cosio, Timothy S. Larson, Mark D. Stegall

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Analysis of 1-year surveillance biopsies was carried out for kidney transplant recipients participating in a randomized trial comparing tacrolimus- and sirolimus-based immunosuppression. The analysis was restricted to recipients remaining on assigned regimen throughout the first posttransplant year. Biopsies from 57 of 84 (68%) tacrolimus-randomized recipients were compared with 38 of 81 (47%) of sirolimus-randomized recipients, the discrepancy being explained by a higher rate of sirolimus discontinuation for non-graft-related complications. Included recipients from the two groups did not differ for baseline characteristics or 1-year iothalamate clearance. Histologic analysis indicated no differences between the groups for glomerular, arterial/arteriolar, or acute interstitial abnormalities. There were, however, significantly higher mean scores in the tacrolimus group for interstitial fibrosis and tubular atrophy with a trend toward higher estimated percent interstitial fibrosis. The results indicate that sirolimus may be associated with reduced early graft fibrosis compared with tacrolimus. This potential benefit is offset by lower success rate in maintaining the regimen and was not accompanied by superior glomerular filtration rate at 1 year.

Original languageEnglish (US)
Pages (from-to)1212-1215
Number of pages4
JournalTransplantation
Volume85
Issue number8
DOIs
StatePublished - Apr 1 2008

    Fingerprint

Keywords

  • Calcineurin inhibitor
  • Chronic allograft nephropathy
  • Histology
  • Kidney transplantation
  • Randomized clinical trial
  • Sirolimus

ASJC Scopus subject areas

  • Transplantation

Cite this