A comparative study on the conversion treatment of the sirolimus quadruple regimen for expanded criteria donor kidney transplantation versus the control group from the same donors
10.12464/j.issn.1674-7445.2025292
- VernacularTitle:扩大标准供者肾移植西罗莫司四联方案的转换治疗同供者对照研究
- Author:
Hua YANG
1
;
Rui XIONG
1
;
Lisong WAN
1
;
Tongzhang CHEN
1
;
Jinran YANG
1
;
Wenfeng LUO
1
;
Xinzhang LI
1
Author Information
1. Department of Organ Transplantation, Jiangxi Provincial People's Hospital (First Affiliated Hospital of Nanchang Medical College), Jiangxi Provincial Key Laboratory of Organ Transplantation, Nanchang 330000, China.
- Publication Type:OriginalArticle
- Keywords:
Kidney transplantation;
Expanded criteria donor;
Immunosuppressive drug;
Sirolimus;
Conversion therapy;
Delayed graft function;
Calcineurin inhibitor;
Estimated glomerular filtration rate
- From:
Organ Transplantation
2026;17(2):243-249
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy and safety of converting the triple immunosuppressive regimen of tacrolimus (Tac) + mycophenolate mofetil (MMF) + prednisone (Pred) to a quadruple regimen of low-dose sirolimus (SRL) + low-dose Tac + MMF + Pred at 3 to 6 months after expanded criteria donor (ECD) kidney transplantation. Methods A single-center, retrospective, donor-matched controlled study included 22 ECD kidney transplant recipients from September 2021 to June 2024. Two recipients from the same donor kidneys were respectively assigned to the SRL group and the conventional triple regimen control group. The main outcome measures were the differences in serum creatinine (Scr), estimated glomerular filtration rate (eGFR), and adverse events before the regimen conversion and after conversion during the 1, 3, 6, and 12-month follow-up. Results There were no statistically significant differences in baseline characteristics between the two groups. In the SRL group, Scr decreased and eGFR increased starting from 3 months after conversion, and this was superior to the control group starting from 6 months(all P < 0.05). There were no statistically significant differences in the incidence of rejection reactions, pulmonary infections, hyperlipidemia and proteinuria between the two groups after conversion and during the 12-month follow-up (all P > 0.05). Conclusions For ECD kidney transplant recipients, converting the triple regimen to the SRL quadruple regimen at 3 to 6 months after transplantation may improve the function of the transplanted kidney without increasing the risk of adverse events.
