HİDEKİ ISHİDA, SHİRO TAKAHARA, NORİTOSHİ AMADA, SHİNJİ TOMİKAWA, TATSUYA CHİKARAİSHİ, KOTA TAKAHASHİ, KAZUHİRO UCHİDA, TAKAHİRO AKİYAMA, KAZUNARİ TANABE, HİROSHİ TOMA
Experimental and Clinical Transplantation - 2016;14(5):518-525
Objectives: Our objectives were to compare the clinical outcomes of mizoribine (12 mg/kg/d) and myco - phenolate mofetil (2000 mg/d) in combination with tacrolimus, basiliximab, and corticosteroids. Materials and Methods: We enrolled 83 recipients of living-donor renal transplant (performed between 2008 and 2013) in this study. This prospective multiinstitutional randomized comparative study compared mizoribine (n = 41) and mycophenolate mofetil (n = 42) in combination with tacrolimus, basiliximab, and corticosteroids for living-donor renal transplant recipients. We compared the acute rejection and graft survival rates and adverse event rates within 1 year of renal transplant between the 2 groups using intentionto- treat analyses. Results: During the 1-year observation period, patient and graft survival rates were 100%. The acute rejection rate was 17.1% in the mizoribine group and 19% in the mycophenolate mofetil group. The incidence rate of cytomegalovirus infection seropositivity (recipient and donor with positive cytomegalovirus antibody status) was higher in the mycophenolate mofetil group than in the mizoribine group, although the difference in these rates was not statistically significant. The incidence of leukopenia was higher in the mizoribine group than in the mycophenolate mofetil group. Conclusions: High-dose mizoribine at 12 mg/kg/day was a safe and efficacious immunosuppressive alter - native to mycophenolate mofetil in living-donor renal transplant recipients. Leukopenia should be closely monitored in the initial period of insufficient kidney function after renal transplant.
