Renal transplantation with expanded criteria donors: Which is the optimal immunosuppression?

Table 4 Modifying and individualizing the immunosuppressive regimen in expanded criteria donor kidney transplantation: Main strategies

Induction with ATG

Reduce overall immunosuppression burden, especially in elderly recipients of ECD kidney transplants

Reduced CNI exposure regimens (target CNI blood levels 25%-50% lower)

Delayed CNI introduction regimens

CNI-free regimens based on MMF and steroids with ATG induction

CNI-free Belatacept-based regimens

Reduced CNI exposure and CNI-free mTOR-inhibitors-based regimens

ATG: Antithymocyte globulin; ECD: Expanded criteria donor; CNI: Calcineurin inhibitor; mTOR: Mammalian target of rapamycin; MMF: Mycophenolate mofetil.