Protocol conversion from a calcineurin inhibitor based therapy to sirolimus.

摘要

Small late-conversion studies found an impressive glomerular filtration rate (GFR) increase 1 year after conversion from calcineurin inhibitor (CNI) to sirolimus (SRL). This effect could not be detected in the considerably larger CONVERT study, which found a lower rate of malignancies in the SRL group. In the spare the nephron trial patients converted to SRL exhibited a mean measured GFR of 68 mL/min at 1 year compared with 60 mL/min from CNI patients (P<0.05). Accordingly, the CONCEPT study which randomized patients to SRL conversion 3 months after transplantation reported a significant higher GFR in the SRL patients at 1 year. These trials showed that conversion of stable renal transplant recipients from CNI to SRL is safe.