Three-yr safety and efficacy of everolimus and low-dose cyclosporine in de novo pediatric kidney transplant patients

Mariano Ferraresso, Mirco Belingheri, Fabrizio Ginevri, Luisa Murer, Luca Dello Strologo, Massimo Cardillo, Angelica Parodi, Giulia Ghirardo, Isabella Guzzo, Annalisa Innocente, Luciana Ghio

Research output: Contribution to journalArticle

Abstract

The three yr results of a multicenter trial in de novo pediatric KT treated with a proliferative signal inhibitor and low dose CNI are presented. Thirty-seven children (9.1 ± 5 yr old) received basiliximab, cyclosporine A (CyA C2:1400 ng/mL), (MMF C0:1.5-3 μg/mL), and prednisone. Three wk later everolimus was started (C0:5-10 ng/mL), CyA was reduced (C2:600 ng/mL after 90 days 300 ng/mL), and MMF discontinued. During the three-yr period patient and graft survivals were 96%. One patient died for causes unrelated to the immunosuppression. Cumulative acute rejection rate including protocol and indication biopsies was 21.9%. None of the patients had signs of chronic humoral rejection. Incidence of dnDSA was 5%, 11%, and 22% at one, two, and three yr post-transplant, respectively. Mean glomerular filtration rate measured at one yr and three yr post-transplant was 105.5 ± 31 and 110.7 ± 27 mL/min/1.73 m2, respectively. A growth velocity of 7.7 ± 6.7 cm/yr was achieved with positive catch-up growth. No malignancy or post-transplant lymphoproliferative diseases were diagnosed. In conclusion, the treatment based on basiliximab induction, everolimus, low-dose cyclosporine, and low-dose prednisone leads to good long-term efficacy in de novo pediatric KT recipients.

Original languageEnglish
Pages (from-to)350-356
Number of pages7
JournalPediatric Transplantation
Volume18
Issue number4
DOIs
Publication statusPublished - 2014

    Fingerprint

Keywords

  • acute rejection
  • cyclosporine
  • donor specific antibodies
  • everolimus
  • long term results
  • pediatric kidney transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation
  • Medicine(all)

Cite this