This journal only 2013, Number 2 Rev Mex Traspl 2013; 2 (2) Early Conversion of calcineurin inhibitors (CNI) to sirolimus (SRL) as maintenance therapy in renal transplant patients: 2-year prospectively followed Martínez-Mier G, Méndez-López MT, Budar-Fernández LF, Ávila-Pardo SF, González-Velázquez F Full text How to cite this article Language: Spanish References: 21 Page: 42-49 PDF size: 243.04 Kb. Key words: mTOR, immunosuppression, renal transplantation. ABSTRACT Objectives: Early conversion from CNI to MMF/SRL regimen has shown benefits in graft function and patient/graft survival with low rejection rate in kidney transplantation. We evaluated the early conversion impact of MMF/SRL in patients withdrawn from CNI. Material and Methods: We prospectively followed 32 patients converted from CNI to SRL before 12 months following transplantation during 25 months. Patients underwent abrupt CNI cessation with SRL introduction and adjustment to maintain 5-10 ng/mL levels. MMF decreased to 1-1.5 gr/day. Results: 19 patients (59.4%) were male. Mean age was 29.6 ± 9.8 years. Most grafts were living donors (n=26, 81.3%). Mean donor age was 41.7 ± 9.5 years. Mean SRL conversion time was 6.1 ± 2.8 months. Postconversion acute rejection rate was 6.25%. All patients has been followed for 9 months. Patient/graft survival was 96 & 90%. BUN decreased throughout the study (p‹0.05), SCr improved (p‹0.005) up to 12 months of follow-up. Mean estimated GFR increased (p‹0.005) up to 18 months of follow-up. 24 hour urine protein excretion was increased (p‹0.05) 3 months after conversion. Withdrawal rate was 12.5%. Conclusions: Early conversion from CNI to SRL in low to moderate risk patients, is safe, well tolerated and associated with a significantly increase in estimated GFR following SRL introduction. REFERENCES Hariharan S, Johnson CP, Bresnahan BA et al. Improved graft survival after renal transplantation in the United States, 1988 to 1996. 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