Comparison of everolimus and low-dose tacrolimus treatment and standard-dose tacrolimus treatment in terms of efficacy and frequency of viral infection in renal transplantation patients

Renal transplantation is the most ideal treatment method for patients with end-stage renal failure. The most important causes of graft loss in renal transplantation are acute rejection and side effects of immunosuppressive therapy. One of the important causes of graft loss is viral infections that occur in the early and late stages. In our study, we compared everolimus and low-dose tacrolimus (EVR+LTac), mycophenolate mofetil and standard-dose tacrolimus (MMF+STac) treatment in terms of efficacy and frequency of viral infections. Our study is retrospective and consists of 98 patients followed in the Organ Transplantation Center in Gaziantep University Hospital. The patients in the EVR+LTac group had a higher mean creatinine than the patients in the MMF+STac group (p= 0.001). The mean GFR of MMF+STac patients was found to be higher than that of EVR+LTac patients (p= 0.006). There was no significant difference between the groups in frequency of CMV infection (p=0.137). Since BK PCR positivity was low, statistical p value could not be calculated. However, there was a significant decrease in the frequency of BK virus infection between 0-6 months in the EVR+LTac group (p= 0.039). There was no difference between the groups in frequency of Covid-19 infection. (p= 0.601). In the EVR+LTac group, a significant relationship was found between the duration of transplantation and the frequency of Covid-19 infection (p= 0.027). A significant correlation was found between the initial tacrolimus drug level and the frequency of Covid-19 infection in the MMF+STac group (p= 0.008). We found that the EVR+LTac regimen reduced the frequency of viral infections but did not provide better GFR compared to MMF+STac. In conclusion, in the light of these findings, we recommend switching to EVR+LTac regimen in order to avoid graft loss in renal transplantation patients with viral infection.