Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Efficacy and Safety of Induction Strategies Combined With Low Tacrolimus Exposure in Kidney Transplant Recipients Receiving Everolimus or Sodium Mycophenolate
Brief Summary: Despite the improvement of efficacy results with current immunosuppressive regimens (about 15% of incidence of acute rejection), the security schemes used do not show the same results.The most worldwide used regime is tacrolimus, mycophenolate and prednisone. Despite the favorable efficacy results in our population, the use of this combination is associated with higher incidence of viral infections such as cytomegalovirus, and gastrointestinal events, two common causes of hospital readmissions after renal transplantation at our institution.Given this, the investigators propose a study of our own initiative that attends our local needs: identify the best strategy among the therapeutic options available to maintain the result of current effectiveness and improve the safety profile for kidney transplant recipients.This protocol is a prospective, randomized, single center, designed to compare the safety and efficacy of three immunosuppressive regimens: (1) single dose of antithymocyte globulin, reduced exposure to tacrolimus, everolimus starting on day 2 after transplantation and prednisone; ( 2) basiliximab, reduced exposure to tacrolimus, everolimus starting on day 2 after transplantation and prednisone; (3-control group) basiliximab, reduced exposure to tacrolimus, mycophenolate and prednisone.Our hypothesis is that a single dose of antithymocyte globulin or basiliximab induction therapy in combination with low doses of tacrolimus, everolimus and prednisone results in comparable efficacy observed in patients receiving tacrolimus / mycophenolate / prednisone, but with a better safety profile.

To ensure efficacy, the investigators added to the regimes the induction with monoclonal or polyclonal antibody. To improve the toxicities associated with the current scheme, the investigators replace the use of mycophenolate by everolimus and the investigators reduced the dose of tacrolimus.

Patients will be monitored for blood levels of tacrolimus and everolimus to ensure adequate exposure to immunosuppressive agents.


Options:
A: Arm Label: A) TEST; Type: ACTIVE_COMPARATOR; Interventions: Drug: A) TEST, Drug: B) CONTROL | Arm Label: B) CONTROL; Type: EXPERIMENTAL; Interventions: Drug: A) TEST, Drug: B) CONTROL | Intervention Type: DRUG; Name: A) TEST; Assigned to Arm(s): A) TEST, B) CONTROL | Intervention Type: DRUG; Name: B) CONTROL; Assigned to Arm(s): A) TEST, B) CONTROL
B: Arm Label: Thymoglobulin and everolimus; Type: EXPERIMENTAL; Interventions: Drug: Thymoglobulin, Drug: Everolimus, Drug: Tacrolimus | Arm Label: Basiliximabe and everolimus; Type: EXPERIMENTAL; Interventions: Drug: Everolimus, Drug: Basiliximabe, Drug: Tacrolimus | Arm Label: Basiliximabe and mycophenolate; Type: ACTIVE_COMPARATOR; Interventions: Drug: Basiliximabe, Drug: mycophenolate sodium, Drug: Tacrolimus | Intervention Type: DRUG; Name: Thymoglobulin; Assigned to Arm(s): Thymoglobulin and everolimus | Intervention Type: DRUG; Name: Everolimus; Assigned to Arm(s): Basiliximabe and everolimus, Thymoglobulin and everolimus | Intervention Type: DRUG; Name: Basiliximabe; Assigned to Arm(s): Basiliximabe and everolimus, Basiliximabe and mycophenolate | Intervention Type: DRUG; Name: mycophenolate sodium; Assigned to Arm(s): Basiliximabe and mycophenolate | Intervention Type: DRUG; Name: Tacrolimus; Assigned to Arm(s): Thymoglobulin and everolimus | Intervention Type: DRUG; Name: Tacrolimus; Assigned to Arm(s): Basiliximabe and everolimus | Intervention Type: DRUG; Name: Tacrolimus; Assigned to Arm(s): Basiliximabe and mycophenolate
C: Arm Label: A; Type: EXPERIMENTAL; Interventions: Drug: Thymoglobulin | Arm Label: B; Type: EXPERIMENTAL; Interventions: Drug: Campath-1H | Arm Label: C; Type: EXPERIMENTAL; Interventions: Drug: Daclizumab | Intervention Type: DRUG; Name: Thymoglobulin; Assigned to Arm(s): A | Intervention Type: DRUG; Name: Campath-1H; Assigned to Arm(s): B | Intervention Type: DRUG; Name: Daclizumab; Assigned to Arm(s): C
D: Arm Label: Mycophenolate sodium; Type: ACTIVE_COMPARATOR; Interventions: Drug: Induction therapy with Thymoglobulin, prednisone, mycophenolate sodium and late introduction of tacrolimus | Arm Label: Everolimus; Type: EXPERIMENTAL; Interventions: Drug: Induction therapy with Thymoglobulin, prednisone, everolimus and late introduction of tacrolimus | Intervention Type: DRUG; Name: Induction therapy with Thymoglobulin, prednisone, everolimus and late introduction of tacrolimus; Assigned to Arm(s): Everolimus | Intervention Type: DRUG; Name: Induction therapy with Thymoglobulin, prednisone, mycophenolate sodium and late introduction of tacrolimus; Assigned to Arm(s): Mycophenolate sodium

Answer: B