Title: SP785Efficacy and effectiveness of CoQ10-micelle compared with CoQ10 on Tac-induced renal injury
Abstract: We selected patients converted to a calcineurin inhibitor due to neoplasia and who were exclusively maintained on an mTOR-is.We studied the incidence and characteristics of the neoplasia, the median time of immunosuppression, and the survival of patients after diagnosis.We studied the graft and patient survival according to their trough levels of mTOR-is at 6 months, 1 year, 2 years and 3 years post-transplant.RESULTS: 70 patients were included, 93% were transplanted with a deceased donor.Medium age at diagnosis of neoplasia was 58,5 years (6 12,6) with a medium time post-transplant of 3,4 years 6 3,5.Ninety percent were solid neoplasia.Skin and genitourinary cancers were the most frequently diagnosed, but lung cancer was associated with the worst survival.The incidence of acute rejection after conversion was 10% (n=7).The incidence of neoplasia recurrence was 4%.Everolimus was the mTOR-Is chosen for conversion in 97% of cases.Median graft survival (censored for death) was 112,9 months (6 3,6).There was a significant difference in outcomes between patients according to their everolimus trough levels at 3 years after conversion (AUROC was 0,64).Patients who maintained everolimus trough levels of 3 -4,9 ng/ml vs 5-8 ng/ml, at 3 years post conversion had superior graft survival (rhos= 0,502, p= 0,009).There were no other significant differences acknowledged at the remaining time points.Comparison between the group of patients with trough levels 3-4,9 ng/ml vs 5-8 ng/ml at 3 years post transplant did not show differences in loss of function or increased proteinuria (p>0,05 for all variables).We didn't find an association between acute rejection and lower trough Mtor-Is levels (Pearson chi2 test, p=0,412).There was one recurrence of neoplasia (squamous cell carcinoma).7% of patients were diagnosed with a second neoplasia while on mTOR-is.CONCLUSIONS: We found that mTOR-is levels of 3-4,9 ng/ml are associated with better outcomes (better graft survival and function) at 3 years post-conversion.Further studies are needed in this specific population to determine the best immunosuppressors to use and how to use them.