Steroid-free maintenance immunosuppression with sirolimus and low-dose cyclosporine in renal transplant recipients is associated with “excellent” long-term patient and graft survival and a low acute rejection rate, according to researchers.

Amer Rajab, MD, PhD, and collaborators at Ohio State University Medical Center studied 791 renal transplant recipients (731 first-transplant and 60 second-transplant patients) who were placed on the steroid-free regimen. Of these patients, 462 received living donor kidneys and 329 received deceased donor kidneys.

At the end of five years, about 85% of patients remained on the regimen and 15% were placed on chronic corticosteroid therapy, the researchers reported. The five-year patient and graft survival rates were 84.5% and 75.4%, respectively. The five-year death-censored graft survival rate was 92.3%.

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During the five-year follow-up, 103 patients died. Forty-two percent died from cardiovascular causes, 39% from sepsis, and 9% from malignancy.