Reduction of Immunosuppressive Load in Renal Transplant Recipients With a Low Donor-Specific Cytotoxic T-Lymphocyte Precursor Frequency is Safe

• Published in: Transplantation proceedings 2005-03, Vol.37 (2), p.779-781
• Main Authors: van de Wetering, J., van der Mast, B.J., de Kuiper, P., van Besouw, N.M., Rischen-Vos, J., IJzermans, J.N.M., Weimar, W.
• Format: Article
• Language: English
• Subjects: Azathioprine - administration & dosage; Azathioprine - therapeutic use; Biological and medical sciences; Creatinine - blood; Dose-Response Relationship, Drug; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - therapeutic use; Kidney Transplantation - immunology; Kidney Transplantation - physiology; Medical sciences; Mycophenolic Acid - administration & dosage; Mycophenolic Acid - analogs & derivatives; Mycophenolic Acid - therapeutic use; Safety; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; T-Lymphocytes, Cytotoxic - drug effects; T-Lymphocytes, Cytotoxic - immunology; Time Factors; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2004.11.061

Tapering of immunosuppressive medication is indicated to prevent long-term side effects. Recently, we have shown that renal transplant recipients can safely be converted from calcineurin inhibitors to MMF or AZA when their donor-specific cytotoxic T-lymphocyte precursor frequencies (CTLpf) are below 10/10 6 PBMC. We wondered whether a low CTLpf also had predictive value when immunosuppressive medication was reduced in patients only on MMF or AZA and steroid medication. Renal transplant recipients with stable renal function at least 2 years after transplantation and with low (