Türkiye Organ Nakli Kuruluşları Koordinasyon Derneği XI. Kongresi, Transplantasyon 2016, Konya, Türkiye, 13 - 15 October 2016, ss.53
Aim : Kidney transplantation (TX)is known to increase the survival of dialysis patients by ameloriating cardiac status including both systolic and diastolic functions. We aimed to evaluate the role of immunosuppressive (IS) drug regimens on cardiac functions of kidney transplant recipients (KTRs). We prospectively evaluated 120 KTRs immediately before and one year after the kidney TX, using tissue Doppler echocardiography.
Method : A triple IS therapy including Tacrolimus, Mycophenoloic Acid (MPA) and Prednisolone was started for all patients. After 3-6 months Tacrolimus dose was lowered in order to achieve target serum levels of 5-8 ng/mL in both groups. MPA was switched to Everolimus with target levels of 4-6 ng/mL, in Group I (N=58) while Group II (N=62) continued with MPA.
Results : No differences in age, gender, dialysis duration, number of HLA mismatches existed between the groups. The prevalence of diabetic or hypertensive nephropathy as the etiology of chronic kidney disease was similar. Blood pressure was strictly controlled. Number of acute rejection episodes was not different in both groups and no graft loss was observed in either group. Improvement in cardiac parameters including ejection fraction (EF), left ventricle diastolic diameter (LVDD), posterior wall thickness (LVPW), left ventricle hypertrophy (LVH) was significantly better before and one year after transplantation. Interestingly, when compared to Group II, ameloriation of all of the parameters mentioned above was even better in Group I patients (p=0.02, p=0.03, p=0.04, p=0.04 respectively)(Table 1).
Conclusion : Better ameloriation of cardiovascular functions with everolimus may favor the choice of this drug in specific group of KTRs.