Table 1. Characteristics of included studies.
| Study ID | Study design | Time to conversion since transplant | Immunosuppressive dosing regime | Outcomes reported | follow up (m) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Method of switching | Pre-conversion | Intervention | Comparator | CNI in the interventionarm after switching | GFR | Graft loss | Mortality | Acute rejection | AEs | ||||
| Wolfgang 2012 [31] | a prospective open-label multicenter RCT (N = 337) | 3 m | Unclear | CsA, EC-MPS, steroids | EVR: Target level (5–10ng/ml), EC-MPS, steroids (N = 171) | CsA, EC-MPS, steroids (N = 166) | Unclear | √ | √ | √ | √ | √ | 12 |
| Thibault 2016 [22] | a prospective multicenter open-label RCT (N = 13) | within 24 h | No conversion | No | EVR: Bolus (6mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 7) | CsA, EC-MPS, steroids (N = 6) | None | √ | √ | √ | √ | √ | 6 |
| Seckinger 2008 [35] | a prospective single-center RCT (N = 39) | 6 m | Tapered | CsA, MPA, steroids | EVR: Target level (6–10ng/ml), MPA, steroids (N = 20) | CsA, MPA, steroids (N = 19) | CsA | √ | √ | √ | √ | √ | 15 |
| Budde 2011 [33] | a prospective multicentrer parallel-group RCT (N = 300) | 4.5 m | Tapered | CsA, EC-MP, steroids | EVR: Bolus (1.5mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 154) | CsA, EC-MPS, steroids (N = 146) | CsA | √ | √ | √ | √ | √ | 12 |
| Mjörnstedt 2012 [30] | an open-label multicenter RCT (N = 202) | 7 w | Abrupt | CsA, EC-MP, steroids | EVR: Bolus (3mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 102) | CsA, EC-MPS, steroids (N = 100) | None | √ | √ | √ | √ | √ | 12 |
| Rostaling 2015 [23] | a prospective open-label multicenter RCT (N = 194) | 3 m | Tapered | CsA, EC-MPS, steroids | EVR: Bolus (3mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 96) | CsA, EC-MPS, steroids (N = 98) | CsA | √ | √ | √ | √ | √ | 12 |
| Chadban 2014 [28] | a prospective multinational open-label RCT (N = 96) | 2 w | Tapered | CsA, MPA, steroids | EVR: Target level (8–12ng/ml), steroids (N = 48) | CsA, MPA, steroids (N = 47) | CsA | √ | √ | √ | √ | √ | 12 |
| Budde 2015 [27] | an open-label prospective parallel-group RCT (N = 93) | > 6m | Tapered | CsA or TaC, EC-MPS, steroids | EVR: Bolus (1.5mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 46) | CsA or TaC, EC-MPS, steroids (N = 47) | CsA or TaC | √ | √ | √ | √ | √ | 12 |
| Bemelman 2009 [34] | a prospective multicenter open-label RCT (N = 77) | 6 m | Tapered | CsA, MPS, steroids | EVR: Target AUC12(150 mg·h/L), EC-MPS, steroids (N = 38) | CsA, MPS, steroids (N = 39) | CsA | √ | √ | √ | √ | √ | 24 |
| Holdaas 2011 [32] | an open-label multicenter RCT (N = 250) | 6 m | Tapered | CsA or TaC, MPA, Aza, steroids | EVR: Target level (6–10ng/mL), MPA, Aza, steroids (N = 127) | CsA or TaC, MPA, Aza, steroids (N = 123) | CsA or TaC | √ | √ | √ | √ | √ | 24 |
| Kihm 2009 [36] | a prospective single-center RCT (N = 32) | 12 m | Tapered | CsA, MPA, steroids | EVR: Bolus (3mg/d), Target level (6–10ng/ml), MPA, steroids (N = 17) | CsA, MPA, steroids (N = 15) | CsA | √ | √ | √ | √ | √ | 24 |
| Budde 2012 [29] | a prospective multicentrer parallel-group RCT (N = 300) | 4.5 m | Tapered | CsA, EC-MPS, steroids | EVR: Bolus(1.5mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 154) | CsA, EC-MPS, steroids (N = 146) | CsA | √ | √ | √ | √ | √ | 36 |
| Mjörnstedt 2015 [25] | an open-label multicenter RCT (N = 202) | 7 w | Abrupt | CsA, EC-MPS, steroids | EVR:Bolus(3mg/d), Target level (6–10ng/ml), EC-MP, steroids (N = 102) | CsA, EC-MPS, steroids (N = 100) | None | √ | √ | √ | √ | √ | 36 |
| Budde (ZEUS) 2015 [24] | a prospective multicentrer parallel-group RCT (N = 300) | 4.5 m | Tapered | CsA, EC-MPS, steroids | EVR: Bolus (1.5mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 154) | CsAEC-MPS steroids (N = 146) | CsA | √ | √ | √ | √ | √ | 60 |
| Budde (APOLLO)2015 [26] | an open-label prospective parallel-group RCT (N = 93) | >6 m | Tapered | CsA or TaC, EC-MPS, steroids | EVR: Bolus (1.5mg/d), Target level (6–10ng/ml), EC-MPS, steroids (N = 46) | CsA or TaC, EC-MPS, steroids (N = 47) | CsA or TaC | √ | √ | √ | √ | √ | 60 |
CsA, cyclosporine A; EVR, everolimus; TaC, tacrolimus; Aza, azathioprine; MPA, mycophenolic acid; CNI,calcineurin inhibitor; EC-MPS, enteric-coated mycophenolate sodium; GFR, glomerular filtration rate; AEs, adverse effects; RCT, randomized controlled trail; h, hour; m, month; w, week.