[Immunosuppressor treatment in kidney transplantation from a live donor]. / Le traitement immunosuppresseur dans la transplantation rénale à partir d'un donneur vivant.

Live-donor transplantations have features that can influence the posttransplantation immunosuppressor treatment: a good-quality kidney and good transplantation conditions, which allow immediate return to kidney function with a high glomerular filtration rate and a lower risk of acute rejection. Very few studies have specifically evaluated the immunosuppressor treatment in the receiver of a kidney from a live donor and many questions remain unanswered. Nevertheless, according to clinical experience, it seems reasonable to use an induction treatment of IL-2 receptor monoclonal antibodies in the receivers of live-donor kidneys (with the exception of HLA-identical transplantations) whether or not the two are related. As for maintenance treatment, it seems important to preserve the number of nephrons in the graft using proliferation signal inhibitors instead of anticalcineurins. On the other hand, for transplantations where the donor and receiver are HLA-identical, it is more difficult to make recommendations because of many unanswered questions, which will remain so as long as specific randomized trials are not conducted.