Dados do Trabalho

Título

Effect of tacrolimus-based regimen conversion to everolimus (EVL) in renal transplant patients on T and B cell subpopulations

Introdução

Previous studies have shown that CNi withdrawal with conversion to mTORi as early as 3 months after transplantation has resulted in improved renal function. However, little is known about the immunomudulatory effects of this conversion to mTORi. In this prospective, single-center, open-label study, we investigated the percentages of circulating regulatory (REG) and proinflammatory (INFLAMMA) lymphocyte subpopulations, renal function, incidence of acute rejection and allograft failure of adult renal allograft recipients before and after conversion from tacrolimus-based regimen to EVL in combination with mycophenolate sodium (MS)

Material e Método

20 renal transplant patients receiving TAC+MS+steroids at 4-8 months after transplantation were divided into 2 groups: EVL group, patients converted to EVL associated with TAC withdrawal, and Control group, maintained regimen. Clinical and laboratory parameters were evaluated before and 12 months after conversion. The periphery cell subpopulations were analyzed by flow cytometry

Resultados

In the EVL group, serum creatinine levels were significantly decreased 12 months after conversion and CKD-EPI was significantly higher. No differences were observed in the control group. There were no episodes of acute rejection after conversion, no graft failure, and no deaths.
12 months after conversion to EVL, patients presented significantly lower levels of effector T-cells, central memory T-cells, Tregs, but increased percentages of naïve B-cells and memory B-cells

Discussão e Conclusões

This study showed that early conversion to an EVR-based regimen with CNI free regimen is safe and efficacious, with improved renal function, besides promoting reduction of effector T-cells, central memory T-cells, Tregs, and increased percentages of naïve B-cells and memory B-cells

Palavras Chave

Imunossupression