Project 2

Systematic Review and Meta-analysis of Calcineurin Inhibitor reduce/free immunosuppression in Solid Organ Transplantation

There is currently a lot of interest in immunosuppression regimens that attempt to reduce the nephrotoxic effects of standard Calcineurin Inhibitor (CNI) based immunosuppression protocols.

The advent of Sirolimus and MMF has paved the way for trials of drug regimens that have reduced CNI’s or are free of CNI’s.

We are currently carrying out an in-depth Systematic Review and Meta-analysis of all RCT’s in solid organ transplantation that compares an immunosuppression regimen that has a reduced dose of, or is free of, CNI’s to a regimen in which normal dose CNI’s are used.

Two abstracts were presented at the BTS in April, 2009. These were entitled:

• Calcineurin Inhibitor Free Immunosuppression Improves Kidney Graft Function but at the expense of increased acute rejection. A Meta-analysis of Randomised Controlled Trials
• The use of Calcineurin Inhibitor Withdrawal Protocols Results in Improved Graft function but an increase in Acute Rejection Rates. A Meta-analysis of Randomised Controlled Trials