Calcineurin Inhibitor (CNI) Versus Steroid Cessation in Renal Transplantation

"Cyclosporine (Group 1):~basiliximab dose: 1x20 mg IV on Day 0 and 1x20 mg IV on Day 4~Cyclosporine: 8 mg/kg PO given before surgery, followed by 2x4 mg/kg/d. C-0h levels: month 1: 150-250 ng/ml; month 2: 100-200 ng/ml; month 3: withdrawal steroids: 100-150 ng/ml.~C-2h levels: month 1: 900-1100 ng/ml; month 2: 800-1000 ng/ml; month 3: withdrawal steroids: maintain level of 750 ng/ml~Enteric-coated mycophenolate(MPA):720mg PO pre-operatively followed by 1.44 g/day.~Steroids: pre-operatively: 250mg methylprednisolone IV; day 1:125mg IV.~Methylprednisolone:day 2-30:PO 12mg/d; day 31-60:tapered to 8mg/d ,day 61-90 :4mg/d; Month 3:stop"

"Everolimus (Group 2):~Basiliximab dose: idem as in group 1~Cyclosporine: first three months idem group 1; month 3: decreased dose by 50%, simultaneously initiate everolimus at a starting dose of 0.75 mg bid.~Once the everolimus blood levels range 6 - 12 ng/ml, cyclosporine will be stopped.~Enteric-coated mycophenolate (MPA) dosing idem as group 1.~Everolimus starting dose: 0.75 mg bid, trough levels: 6-12 ng/ml.~Steroid dosing: idem group 1, but maintained at 4 mg methylprednisolone after day 60."