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document
Humoral immunity after kidney transplantation : impact of two randomized immunosuppressive protocols . BACKGROUND Controlling alloimmune humoral response is a challenge in transplantation . Few studies have evaluated the impact of maintenance immunosuppression on blood humoral parameters . MATERIAL/METHODS We performed a post-hoc analysis on 307 kidney transplant recipients included in a prospective randomized trial comparing tacrolimus/mycophenolate mofetil ( Tac/MMF ) vs. cyclosporine/azathioprine ( CsA/AZA ) , both used with antithymocyte globulin induction and steroids . Humoral parameters were analyzed at D0 , D15 , and M12 . RESULTS IgG , IgA , and IgM levels decreased significantly as soon as D15 in both groups ( –35 % , –26 % , and –35 % respectively , vs. D0 ) . At M12 , although peripheral B-cell counts did not differ between the groups , Tac/MMF regimen was associated with lower IgG , IgA , and IgM levels than CsA/AZA ( –5.9 % , –14.6 % , and –34 % , respectively ) . Hypogammaglobulinemia at D15 was not associated with an increased risk of infections during the first year . The proportion of HLA-sensitized patients decreased in the Tac/MMF group ( 15.9 % at D0 and 6.7 % at M12 , p=0.02 ) and remained stable in the CsA/AZA group ( 10.3 % at D0 and 8.9 % at M12 , p=0.5 ) . More patients sensitized at baseline became non-sensitized at M12 with Tac/MMF than with CsA/AZA . CONCLUSIONS Our results suggest humoral immunosuppression is better with Tac/MMF than with CsA/AZA during the first year of kidney transplantation .
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Intervention_Pharmacological
tacrolimus/mycophenolate mofetil ( Tac/MMF ) vs. cyclosporine/azathioprine ( CsA/AZA )
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Intervention_Pharmacological
antithymocyte globulin induction
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Intervention_Pharmacological
steroids .
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Outcome_Physical
IgG , IgA , and IgM levels
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Participant_Condition
Humoral immunity after kidney transplantation :