To evaluate the short and long term outcomes of renal transplant recipients with low dose Everolimus, Tacrolimus - based minimal quadruple immunosuppressive regimen

The aim of the study is to evaluate the long term outcome following renal transplantation with a combination of low dose quadruple immunosuppression. Group-I (n = 25) comprised of low dose everolimus (0.5 mg/bd) (EVR), low dose Tacrolimus (1mg/bd), low dose mycophenolate sodium (360mg/bd) and prednisolone. Group II (n = 29) consisted of standard triple drug regimen of tacrolimus (3mg/bd), mycophenolate sodium (720mg/bd) and prednisolone. Renal function, rejection episodes, adverse events, graft and patient survival were analyzed.Results and discussion: There was an improvement in the renal function from 1-year post transplant to the end of the study period in Group I. The mean serum creatinine at 10 years was1.54 ± 0.44 and in Group II it was 2.1 ± 0.7mg/dl with a statistical significance of p = 0.005. Mean eGFR at 10 years in Group-I was 57.8 and in Group II it was 46.7ml/mt/1.73m2 (p= <0.05). There was no statistical difference between the two groups in rejection rates (Group I-12% Group-II -17.24% (p = 0.65), graft loss (Group-I-12% vs Group II-27%(p= 0.26) and the patient loss was (Group I -12% vs Group-II 24%(p = 0.36). Drug related adverse events were insignificant. Proteinuria and hyperlipidemia were comparable between the groups. The low dose quadruple immunosuppression protocol was a better option for long-term graft survival with fewer complications.