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The beneficial effect of high-dose mizoribine combined with cyclosporine, basiliximab, and corticosteroids on CMV infection in renal transplant recipients

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Abstract

Background

Mizoribine (MZR) has been developed as an immunosuppressive agent, but has a less potent immunosuppressive effect up to 3 mg/kg/day MZR. Therefore, we investigated whether high-dose MZR, at 6 mg/kg/day, would be effective and safe for kidney transplant patients in conjunction with cyclosporine (CsA), basiliximab, and corticosteroids.

Methods

A total of 40 living related patients were administered MZR (6 mg/kg/day), CsA (7 mg/kg/day), prednisolone (maintenance dose 10 mg/day), and basiliximab (20 mg/body). A control group (n = 38) treated with CsA, mycophenolate mofetil (MMF, 25 mg/kg/day), basiliximab, and corticosteroids was also employed in this study.

Results

The 2-year graft survival rates for the MZR and MMF groups were 100 and 94.7 %, respectively. The rejection rate in the MZR group (25 %) was not significantly higher than that in the MMF group (16 %). Serum creatinine level was not significant between the two groups. The number of patients who developed cytomegalovirus (CMV) disease was 0 (0 %) in the MZR group and 7 (18.4 %) in the MMF group (P < 0.05). The number of patients treated with ganciclovir was 3 (7.5 %) and 11 (28.9 %) (P < 0.05), respectively.

Conclusions

The combination of high-dose MZR with CsA, basiliximab, and corticosteroids can establish not only satisfactory immunosuppression but also a low rate of CMV infection in vivo.

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Acknowledgments

Presentation of material in submitted manuscript: Presented in part at the World Transplant Congress, Boston, MA, July 22–27, 2006.

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Authors and Affiliations

  1. Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, 465 Hirokoji, Kawaramachi, Kamikyo-ku, Kyoto, 602-8566, Japan

    Norio Yoshimura, Hidetaka Ushigome, Kiyokazu Akioka, Syuuji Nobori, Tomoyuki Suzuki, Kazuki Sakai & Masahiko Okamoto

  2. Department of Organ Interaction Research Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Norio Yoshimura & Masahiko Okamoto

Authors
  1. Norio Yoshimura
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  2. Hidetaka Ushigome
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  3. Kiyokazu Akioka
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  4. Syuuji Nobori
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  5. Tomoyuki Suzuki
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  6. Kazuki Sakai
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  7. Masahiko Okamoto
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Correspondence to Norio Yoshimura.

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Yoshimura, N., Ushigome, H., Akioka, K. et al. The beneficial effect of high-dose mizoribine combined with cyclosporine, basiliximab, and corticosteroids on CMV infection in renal transplant recipients. Clin Exp Nephrol 17, 127–133 (2013). https://doi.org/10.1007/s10157-012-0669-4

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  • DOI: https://doi.org/10.1007/s10157-012-0669-4

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