Is short term outcome of Iranian renal transplant recipients affected by mean first 6 months C2 level?

Abstract

International Consensus Conference (ICC) has suggested that the whole blood level of Cyclosporine (CsA) be kept strictly at a certain level. However, it is not well understood whether failing to maintain these levels will affect the short term outcome in different patient populations or not. We aimed to assess if the short term outcome of Iranian renal transplant recipients will be affected by first 6 months C2 level. In a retrospective cohort, 265 consecutive kidney transplant recipients were categorized as group with mean C2 lower than recommended range (mean C2 levels in the first 6 month after transplantation lower than the recommended ranges; n=213) and group with mean C2 within recommended range (mean C2 levels in the first 6 month after transplantation within the recommended range; n=52). All recipients were negative for panel reactive antibody, and had received their first (living unrelated) kidney transplantation in Baqiyatallah hospital, between 2002 and 2003. The groups were similar in characteristics and 6 months, 1, 2, and 3 years patient and graft survival rates were considered as outcome. No significant difference was observed in patient and graft survival rates between the two groups (P > 0.05). The patient survival rate in group with mean C2 lower than recommended range and group with mean C2 within recommended range were: 6 months: 98% vs. 98, 1 year: 97% vs. 98%, 2 years: 97% vs. 98% and 3 years: 97% vs. 98%. The graft survival rate in the above groups were as follows: 6 months: 93% vs. 91%, 1 year: 92% vs. 91%, 2 years: 92% vs. 77% and 3 years: 89% vs. 69%, respectively. The result of our study showed that lower mean C2 levels was not necessarily accompanied with a worse short term outcome in our patients. This finding suggests that the optimal level of C2 may be different in ethnic populations.