Safety and efficacy of TOR inhibitors and other immunosuppressive regimensin African-American renal transplant recipients

African-American renal transplant recipients have higher rates of acute all ograft rejection and lower rates of allograft survival compared with Caucas ian patients, and these differences have not been eliminated by a new gener ation of potent immunosuppressive drugs. In particular, African-Americans t end to exhibit higher rejection rates after withdrawal of corticosteroid th erapy. Based on promising early results using the combination of sirolimus and low-dose tacrolimus in liver, kidney-pancreas, and islet-cell transplan t recipients, our center is conducting a pilot study of this immunosuppress ion regimen in African-American patients. As of April 2001, there has been only 1 acute rejection episode (2.8%) in this cohort. Long-term follow-up o f these patients will be necessary to assess the benefits and risks of this regimen. (C) 2001 by the National Kidney Foundation, Inc.