Comparison of tacrolimus vs cyclosporine in high-risk kidney transplantation patients

Abstract

Objective To observe and compare the afficacy and safety of tacrolimus vs cyclosporine in high-risk kidney transplantation patients. Methods According to the different immunosuppres sive regimens,147 cases of high-risk kidney transplantation patients from Jan. 1999 to Dec.2000 (including 88 cases of secondary transplantation and 59 cases of first transplantation patients whose PRA level were higher than 50% before operation) were divided into two groups:53 cases in tacrolimus group and 94 cases in cyclosporine A group. The indications between two groups were compared,including grafts survival,serum creatine level,and the incidence of complications after operation.Results The 1,3,5 year grafts survival rate in tacrolimus group was 86.8%,82.3%,75.3%,respectively,and that in cyclosporine group was 81.9%,75.4%,66.9%,respectively,with the difference being no statistically significant(P＞0.05). The creatine level one year after operation was (100.72±15.88)μmol/L in tacrolimus group,sinificantly lower than that in tacrolimus group (117.29±11.77)μmol/L(P＜0.01). Compared with cyclosporine group,the incidence of acute rejection,chronic rejection,impairment of liver function,hypertension and hyperlipidemia were significantly reduced in tacrolimus group(P＜0.05),while the incidence of hyperglycemia was significantly increased in tacrolimus group(P＜0.01).The incidence of DGF and infection had no significant difference between two groups(P＞0.05). Conclusions Compared with cyclosporine,tacrolimus can effectively reduce the incidence of acute rejection,chronic rejection and other complications in high-risk patients after kidney transplantation. Tacrolimus is very efficient and safe for the high-risk kidney transplantation patients. Key words: Kidney transplantation; Tacrolimus; Graft rejection;