Longevity & AgingLow-Dose Immunosuppression Fails to Beat Standard Therapy in Older Kidney Transplant Patients
Older adults are receiving more kidney transplants, but they are frailer and more prone to infections, cancer, and heart problems than younger recipients. Doctors have wondered whether giving them lower doses of anti-rejection drugs would be safer. The OPTIMIZE trial tested this in 379 transplant recipients aged 65 or older across seven European centers. Half received low-dose tacrolimus plus everolimus and prednisolone. The other half received standard-dose tacrolimus plus mycophenolate and prednisolone. After two years, 50% of the low-dose group and 57% of the standard group met the definition of successful transplantation (alive with a graft meeting a kidney function threshold). This difference was not statistically significant. Survival, graft survival, kidney function, and infection rates were also similar. The results suggest that standard immunosuppression remains a reasonable choice for older recipients.
