Comparative Study of Clinical Outcome in Kidney Transplantation Between Early Steroid Withdrawal Protocol Using Basiliximab, Calcineurin Inhibitor, and Mycophenolate Mofetil and Triple Regimen Consisting of Calcineurin Inhibitor, Mycophenolate Mofetil, and Steroid

2005 ◽  
Vol 37 (2) ◽  
pp. 791-794 ◽  
Author(s):  
S. Teraoka ◽  
S. Sato ◽  
M. Sekijima ◽  
K. Iwado ◽  
Y. Urashima ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Kidney Transplantation ◽  
Clinical Outcome ◽  
Comparative Study ◽  
Calcineurin Inhibitor ◽  
Steroid Withdrawal ◽  
Triple Regimen

P1636THE IMPACT OF CALCINEURIN INHIBITOR WITHDRAWAL ON DE NOVO DSA PRODUCTION IN LIVING DONOR KIDNEY TRANSPLANTATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Takahisa HIRAMITSU ◽  
Akiko Kanda ◽  
Kenta Futamura ◽  
Toshihide Tomosugi ◽  
Manabu OKADA ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Kidney Transplantation ◽  
Living Donor ◽  
Calcineurin Inhibitor ◽  
De Novo ◽  
Significant Risk ◽  
Donor Kidney ◽  
Living Donor Kidney Transplantation ◽  
Donor Kidney Transplantation ◽  
Living Donor Kidney

Abstract Background and Aims Chronic antibody mediated rejection caused by de novo donor specific antibody (dnDSA) is one of the biggest reasons for graft failure. At present, because it is difficult to treat CAMR, prevention of de novo DSA production is important. We investigated the risk factor for dnDSA production in living donor kidney transplantation. Method 807 patients underwent living donor kidney transplantation between January 2008 and December 2016. 159 recipients were excluded because of preformed DSA (58 recipients), pediatric transplantation (35 recipients), pancreas transplantation after kidney transplantation (4 recipients), and insufficient data on DSA after transplantation (62 recipients). 648 recipients were enrolled in this study. In 84 out of 648 recipients, dnDSA were detected until December 2018. With cox regression analysis, the risk factors for de novo DSA production were investigated between dn DSA positive and negative groups. The impact of donor characteristics including age and sex, and recipient characteristics including age, sex, hemodialysis vintage, cold ischemic time, past history of transfusion, pregnancy, and transplantation, HLA mismatch, pre-operative Flow PRA results, ABO incompatibility, rituximab induction, splenectomy, pre-operative plasmapheresis, transplantation from first-degree relatives, conversion of calcineurin inhibitor (CNI), conversion of mycophenolate mofetil, mizoribin, and everolimus, CNI used for induction, induction with mycophenolate mofetil, mizoribin, and everolimus, CNI withdrawal, withdrawal of mycophenolate mofetil, mizoribin, and everolimus, and rejection within 6 months after transplantation were investigated. Results In the univariate analysis, male recipient, male donor, and CNI withdrawal were the significant risk factors (P=0.020, HR 1.795, 95%CI 1.095-2.942; P=0.027, HR 0.568, 95%CI 0.344-0.938; P<0.001, HR 6.346, 95%CI 2.560-15.730, respectively). In the multivariate analysis, calcineurin inhibitor withdrawal was significant risk factor with P<0.001, HR 6.374, 95%CI 2.567-15.828. Conclusion Calcineurin inhibitor withdrawal was the significant risk factor for de novo DSA production in living donor kidney transplantation

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