No Difference in Degree of Interstitial Sirius Red-Stained Area in Serial Biopsies from Area under Concentration-over-Time Curves-Guided Cyclosporine versus Tacrolimus-Treated Renal Transplant Recipients at One Year

A. T. Rowshani
2005 Journal of the American Society of Nephrology  
Interstitial fibrosis is the main characteristic of chronic allograft nephropathy and long-term graft failure. Cyclosporin (CsA) is thought to be more fibrogenic than tacrolimus. In a prospective, randomized, multicenter trial using a calcineurin-sparing regimen, renal interstitial volume was compared in CsA-and tacrolimus-treated renal transplant recipients by image analysis of Sirius red (SR)-stained cortical areas in protocol biopsies obtained at 6 mo (n ‫؍‬ 94) and 12 mo (n ‫؍‬ 97) after
more » ... nsplantation. Immunosuppression consisted of CsA or tacrolimus, CD25 mAb, mycophenolate mofetil, and prednisolone. CsA therapy increased the 6-mo risk for subclinical rejection. The prevalence of subclinical rejection was 38.8% in the CsA-treated and 15.2% in the tacrolimus-treated patient group (P ‫؍‬ 0.012). Strikingly, no difference in the degree of interstitial SR-stained area was detectable between the two treatment groups. In particular, previous subclinical rejection episodes did not influence the degree of interstitial volume. Also, no difference in GFR occurred at 1 yr, when the mean GFR mounted 63 ml/min. No significant differences in the degree of interstitial SR-stained area could be observed at 6 and 12 mo between CsA-and tacrolimus-treated renal transplant recipients. Although CsA-treated patients developed significantly more subclinical rejections at 6 mo, this did not influence the degree of SR staining or the change in renal function at 1 yr. Published online ahead of print. Publication date available at www.jasn.org. A.T.R. and E.M.S. contributed equally to this work.
doi:10.1681/asn.2005030249 pmid:16306168 fatcat:oj4miwnr7bcvva4ndl6cujcw7i