Sirolimus improves the two-year outcome of renal allografts in African-American patients

The present study evaluated whether the addition of sirolimus to a cyclospo rine (CyA)/prednisone (Pred) regimen mitigated the greater proclivity to ac ute rejection episodes and graft loss characteristic of African-American re nal transplant recipients. Using Kaplan-Meier and log-rank tests, African-A merican renal transplant recipients treated with either CyA/Pred (n = 90) o r sirolimus/CyA/Pred (n = 47) were compared with 120 Caucasian patients tre ated with sirolimus/CyA/Pred for 2-year rates of patient and graft survival as well as acute rejection episodes. Mean laboratory values were compared using analysis of variance and F-tests. Addition of sirolimus to the CyA/Pr ed regimen reduced the incidence of acute rejection episodes in African-Ame ricans from 43.3 % to 19.2 % (P = 0.004), a value similar to Caucasian pati ents. The 97.9 % 2-year graft survival rate among 47 African-American patie nts treated with sirolimus/CyA/Pred was significantly higher than the 85.6 % rate shown among the 90 CyA/Pred-treated African-American transplant reci pients (P = 0.0479) and similar to that in Caucasians. The 95.7 % patient s urvival rate among the African-American sirolimus/CyA/Pred group was simila r to the 97.8 % rate in the African-American CyA/Pred cohort. Interestingly , there was no evident toxicity from the addition of sirolimus. The additio n of sirolimus to a CyA-based regimen reduced acute rejection episodes and graft loss experienced by African-American renal transplant recipients.