Incidence of Delayed Graft Function and Wound Healing Complications After Deceased-Donor Kidney Transplantation Is not Affected by De Novo Everolimus

Background. Concerns about delayed graft function (DGF) a rid Wound healing complications with sirolimus has led to Suggestions that everolimus introduction could be delayed after transplantation. Methods. In a prospective, multicenter, open-label Study, deceased-donor kidney transplant recipients at protocol-specified risk of DGF (defined as >= 1 dialysis session during the first week posttransplant excluding day 1) were randomized to start everolimus therapy on day 1 posttransplant (immediate everolimus [IE]), or from week 5 (delayed everolimus [DE]) with mycophenolic acid until everolimus was initiated. All patients received anti-interleukin-2 receptor antibodies, cyclosporine A, and corticosteroids. A planned 3-month analysis from this 12-month study is presented here. Results. One hundred and thirty-nine patients were randomized (IE 65, DE 74), The primary composite endpoint: biopsy-proven acute rejection, graft loss, death, DGF, wound healing events, or lost to follow-up at month 3, Occurred in 36 IE patients (55.4%) and 47 DE patients (63.5%, P=0.387). The incidence of DGF was similar between groups (IE 24.6%, DE 24.3%; n.s.). Wound healing events of any type occurred in 40.0% and 41.9% of IE and DE patients (n.s.); events relating to initial transplant surgery occurred in 36.9% IE patients and 37.8% DE patients (n.s.), most of which were fluid collections. Study drug was discontinued due to adverse events or graft loss in 13 IE (20.0%) and 17 DE patients (23.0%). Conclusions. Findings from this randomized, Multicenter trial indicate that kidney function recovery, wound healing, efficacy, and tolerance are similar at 3 months posttransplant with immediate or DE in patients at protocol-specified risk of DGF.