Impact of Immunosuppressive Medications on CRS and ESS in Kidney and Liver Transplant Recipients

Sunday, October 12, 2025

1:36 PM - 1:42 PM EDT

Location: 125

Disclosure(s):

Bastien A. Valencia, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Prishae M. Wilson, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Angela M. Donaldson, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Transplant recipients have a higher prevalence of chronic rhinosinusitis (CRS) than the general population, potentially due to immunosuppressive medications. To date, the association between immunosuppressive regimens and CRS development remains unexplored. This study examines the impact of immunosuppressive regimens on CRS development in kidney and liver transplant recipients.

Methods: Data were retrospectively collected from all Mayo Clinic sites using the Mayo Data Explorer. Patients who underwent kidney or liver transplantation between November 1, 2021, and November 1, 2022, were included. Demographic data, relevant comorbidities, CRS diagnoses, and immunosuppressive regimens were collected.

Results: 1,459 transplant recipients (986 kidney, 473 liver) with a mean age of 55.1 years and M:F ratio of 1.5:1 were included. Kidney recipients who received anti-thymocyte globulin (ATG, Thymoglobulin®) for immunosuppressive induction had a higher risk of CRS compared to those who did not (OR = 3.0, 95% CI [1.3, 6.9], p = 0.005). Among liver recipients, patients on cyclosporine, mycophenolate mofetil (MMF), and corticosteroids had a higher risk of CRS compared to those on tacrolimus-based regimens (OR = 6.0, 95% CI [1.5, 24.1], p = 0.027). Cyclosporine use was also associated with a higher rate of ESS compared to tacrolimus (4.2% vs 0.3%, p = 0.015).

Conclusions: ATG and cyclosporine-based regimens are associated with an increased risk of CRS following kidney and liver transplantation. Cyclosporine use is also associated with higher rates of surgical intervention (ESS) for symptom control. These findings may inform patient counseling and guide surgical decision-making in this population.

Presenting Author(s)

HD

Hannah Daniel

Lubbock, Texas, United States

Disclosure information not submitted.

Co-Author(s)

Bastien A. Valencia, MD

Postdoctoral Research Fellow
Mayo Clinic
Jacksonville, Florida, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Prishae M. Wilson, BS

Research Fellow
Mayo Clinic
Columbia, South Carolina, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
NN

Natasha Najmi, BS

Mayo Clinic in Florida, United States

Disclosure information not submitted.
HW

Hani M. Wadei, MD

Professor of Medicine
Mayo Clinic in Florida
Jacksonville, FL, United States

Disclosure information not submitted.
DH

Denise Harnois, DO

Mayo Clinic in Florida, United States

Disclosure information not submitted.

Senior Author(s)

AD

Angela M. Donaldson, MD

Associate Professor
Mayo Clinic
Jacksonville, FL, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.