Conversion to Tacrolimus Immunosupression in Renal Transplant Recipients: 12-Month Follow-up

Tacrolimus is a macrolide derived from the fungus Streptomyces tsukubaensis, has powerful immunosuppresive actities that have been shown in prospective, randomized, international clinical? trials to significantly reduce the incidence of acute rejection after kidney transplantation. It is known whether the reduced incidence of acute rejection episodes will translate in better long-term graft survival. At this time, chronic renal allograft dysfunction (CRAD), being the major cause of graft loss, is the new frontier to be conquered in transplantation. No strategy has been designed with current immunosuppression to adress theissue of CRAD. Although international experiences have established the role of tacrolimus immunosuppression in preventing acute immune complications, less is known on the potential applications in the chronic unstable and stable patients. We designated a study to evaluated the efficacy and safety of converting kidney transplant recipients with declining renal function and immunosuppressive drug side effects that reduce quality of life to tacrolimus. We report the 12-month follow-up of efficacy parameters after conversion to tacrolimus immunosuppression for CRAD. Our data showedv that in 60% of cases, conversion to tacrolimus for deteriorating renal function, was followed by amelioration or stabilization of renal function. Longer follow-up is required to corroborate these preliminary data, but conversion to tacrolimus may be considered a reasonable option to prolong the function of the chronically deteriorating renal allograft.