Recovery of graft function in pediatric kidney transplantation is not affected by delayed introduction of cyclosporine.

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Publication year
2008Source
Transplantation, 86, 9, (2008), pp. 1199-205ISSN
Publication type
Article / Letter to editor

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Organization
Paediatrics - OUD tm 2017
Journal title
Transplantation
Volume
vol. 86
Issue
iss. 9
Page start
p. 1199
Page end
p. 205
Subject
IGMD 9: Renal disorder; UMCN 5.4: Renal disordersAbstract
BACKGROUND: Delayed graft function and acute rejections adversely affect the long-term survival of kidney transplantation. To decrease the incidences of these phenomena, we changed the initial immunosuppressive protocol in pediatric kidney transplantation in The Netherlands. METHODS: We compared a cohort (n=123) treated with basiliximab and delayed onset cyclosporine (CsA) with the preceding cohort (n=110) in which CsA was started already preoperatively. Both cohorts were treated with mycophenolate mofetil and corticosteroids as well. All consecutive transplantations were included. RESULTS: The incidence of delayed graft function did not significantly differ between the cohorts (10% and 13%, in basiliximab and control group). Significantly fewer patients in the basiliximab group had acute rejection episodes (20% vs. 36% in control group, P=0.007). The mean estimated glomerular filtration rate at 1 year and graft survival at 2 years posttransplant did not differ between groups (62 vs. 64 mL/min 1.73 m2, and 89% vs. 92%, respectively). CONCLUSION: Postponed onset of CsA in triple immunosuppressive therapy (corticosteroids, CsA, and mycophenolate mofetil) with addition of basiliximab did not reduce the incidence of delayed graft function in pediatric kidney transplantation. Yet, fewer acute rejections were noted. Long-term favorable effects could not be detected in this study.
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- Faculty of Medical Sciences [86198]
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