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

African-American renal transplant recipients have higher rates of acute allograft rejection and lower rates of allograft survival compared with Caucasian patients, and these differences have not been eliminated by a new generation of potent immunosuppressive drugs. In particular, African-Americans tend to exhibit higher rejection rates after withdrawal of corticosteroid therapy. Based on promising early results using the combination of sirolimus and low-dose tacrolimus in liver, kidney-pancreas, and islet-cell transplant recipients, our center is conducting a pilot study of this immunosuppression 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 of these patients will be necessary to assess the benefits and risks of this regimen. (C) 2001 by the National Kidney Foundation, Inc.