Advantages of Sirolimus in a Calcineurin-Inhibitor Minimization Protocol for the Immunosuppressive Management of Kidney Allograft Recipients

A myriad of immunosuppressive agents is currently available for the management of graft recipients; however, a consensus on the optimum immunopharmacological plan is nonextant. Twenty kidney recipients on quadruple (mycophenolate mofetil, prednisone, cyclosporine A or tacrolimus, and sirolimus) therapy and 85 on triple therapy where sirolimus was excluded were analyzed for graft rejection or loss within a posttransplant surveillance period of 3 years. Only 1 of 20 recipients (5%) on quadruple therapy experienced a rejection episode. On the other hand, 13 of 85 recipients (15.3%) on triple therapy had a rejection episode or lost the graft. Overall, 14 of 105 recipients (13.3%) experienced a rejection episode or kidney loss. Our observations indicate that an immunosuppressive regimen including sirolimus is advantageous for the management of kidney allograft recipients in the short term.