gms | German Medical Science

Background: Based on international recommendations combined immunosuppression is used after kidney transplantation in children. A common regimen was based on Steroids, Mycophenolat-Mofetil and Cyclosporin A with Il-2-antagonist induction. One third of the patients had to be switched from Cyclosporin A to Tacrolimus, due to dermatologic cosmetic side effects. Thus, TABIC was established as a novel immunosuppressive regimen. Aim of the present registry is to perform quality assurance and to evaluate a risk/benefit analysis of the TABIC-regimen compared to previous immunosuppressive regimens in children undergoing kidney transplantation at our center.

Method: In this observational single-center study, 34 consecutive patients undergoing kidney transplantation between December 2005 and November 2011 at our center, were enrolled. Patients who were not treated according to the TABIC-scheme served as a historic control. The end-point was a combination of death and graft loss.

Preliminary results: 6 patients (20%) had to be switched from Tacrolimus to Rapamycin due to side effects. Furthermore, 5 patients (16%) suffered from acute rejection, but no graft loss was observed. Within follow-up, no patient reached the combined end-point (100% kidney transplant as well as 100% patients survival). A Kaplan-Meier-analysis revealed a significantly better outcome for patients treated with the TABIC-scheme compared to controls (5 years event free survival, TABIC vs. non-TABIC: 100% vs. 79%, p=0,048).

Conclusion: So far our data show that the TABIC-regimen is efficient and safe compared to Cyclosporin A based immunosuppression. Tacrolimus is associated with a significantly better graft and patient survival. Therefore, it should be considered as standard therapy after kidney transplantation in children.