Application of calcineurin inhibitor monotherapy in renal transplantation after alemtuzumab induction:a Meta-analysis / 器官移植

ABSTRACT

Objective To evaluate the clinical efficacy and safety of immunosuppression of calcineurin inhibitor monotherapy (AiCNIm)after alemtuzumab induction following renal transplantation.Methods Randomized control clinical trials related to application of AiCNIm (AiCNIm group ) and conventional triple regimes (Triple group ) for immunosupression after renal transplantation,published from 1 980 to December 31 201 4,were searched online from PubMed,Embase,Web of Science,Cochrance library and China National Knowledge Infrastructure (CNKI) databases.Meta-analysis was performed by Rev Man 5.2 software.Results Five randomized control studies consisting of 421 renal transplant recipients were included.The results of follow up for 6-1 2 months revealed that compared with the Triple group, the incidence of rejection response confirmed by acute rejection or aspiration biopsy in the AiCNIm group was significantly lower [relative risk (RR) =0.59,95% confidence interval (CI)0.40-0.89 ].However,there was no significant difference in the risk of renal allograft dysfunction (RR =0.85,95%CI0.38-1 .87),death of recipient (RR =0.89,95%CI0.30-2.67),infection (RR =1 .03,95%CI0.91 -1 .1 7)and new-onset diabetes after transplantation (RR =0.62, 95%CI0.29-1 .30)between two groups (all in P >0.05).Conclusions According to the existing evidence,application of calcineurin inhibitor monotherapy after renal transplantation exerts short-term immunosuppressive effect and high safety after alemtuzumab induction.