Statins benefit outcomes of renal transplant recipients on a sirolimus-cyclosporine regimen

Transplant Proc. 2007 Dec;39(10):3086-92. doi: 10.1016/j.transproceed.2007.10.008.


Background: Statins offer a strategy to address dyslipidemia commonly experienced by immunosuppressed transplant recipients.

Methods: This single-center, retrospective study of 325 recipients (mean posttransplant follow-up of over 6 years; 75.0+/-26.0 months) correlated four adverse outcomes-biopsy-confirmed acute rejection episodes, biopsy-confirmed chronic rejection/allograft nephropathy, graft loss, or death-with demographic and posttreatment variables. Patients were treated with a combination of sirolimus (SRL), cyclosporine (CsA), and various durations of steroids. Statins were prescribed for 259/325 (79%) recipients whose serum cholesterol exceeded 240 mg/dL and discontinued when the creatine phosphokinase increased fivefold (3.4%) or the liver function, threefold (3.0%) above normal.

Results: Upon univariate (hazard ratio [HR] 0.16; P<.001) and multivariate analysis (HR 0.38; P=.02), statins were markedly protective against acute rejection episodes. They reduced occurrence of chronic nephropathy/chronic rejection (HR 0.60; P=.03 and HR 0.52; P=.01, respectively). Incidences of graft loss were diminished (HR 0.26; P<.001 and HR 0.49; P=.01, respectively). Finally, the mortality rate was decreased (HR 0.21, P=.001 and HR 0.26, P=.01, respectively). Upon multivariate analysis, a reduced incidence of acute rejection was correlated with greater exposure to SRL (HR 0.78, P=.016) and CsA (HR 0.39; P=.006).

Conclusions: This study demonstrated compelling effects of statins against all adverse outcomes among patients treated with SRL-based, CsA-containing regimens. The profoundly dyslipidemic properties of SRL may explain these unique findings compared with previous studies on patients treated with CsA-based regimens.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cholesterol / blood
  • Cyclosporine / therapeutic use*
  • Drug Prescriptions
  • Drug Therapy, Combination
  • Female
  • Graft Rejection / epidemiology
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / drug therapy
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Transplantation / immunology
  • Kidney Transplantation / physiology*
  • Male
  • Middle Aged
  • Peritoneal Dialysis / statistics & numerical data
  • Retrospective Studies
  • Sirolimus / therapeutic use*


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Immunosuppressive Agents
  • Cyclosporine
  • Cholesterol
  • Sirolimus