The differential metabolic impact of tacrolimus and cyclosporine immunosuppression in black heart transplant recipients: hyperlipidemia, hypertension and hyperglycemia

Abstract

disease in 10, viral cardiomyopathy in 9, hypertrophic cardiomyopathy in 7, congenital heart disease in 6, and others in 14. The follow-up was 3.863.1 years (minimum 2 days, maximum 10.2 years, median 3.1 years). Thirty-day-mortality rate was 5.5%. The 1, 5, and 10-year actuarial survivals were 86%, 75%, and 54%, respectively. Cause of death for the entire group (total 69) were infection in 18(26% of deaths), graft coronary disease in 12(17%), acute rejection in 8(11.6%), stroke in 6(8.7%), malignancy in 4(5.8 %), primary graft failure in 4(5.8%), other causes in 13(18.8%), and unknown in 4(5.8%). Actuarial freedom from acute rejection at 1, 3 months, 1, 5, and 10 years was 64.4%, 54.1%, 43.7%, 40.1%, and 40.1%, respectively. Actuarial freedom from acute rejection-related death at 3 months, 1, 5, and 10 years was 98.2%, 97.7%, 95.4%, and 95.4%, respectively. Actuarial freedom from infection at 1, 3 months, 1, 5, and 10 years was 91.4%, 81.6%, 69.4%, 58.8%, and 54.2%, respectively. Actuarial freedom from infection-related death at 3 months, 1, 5, and 10 years was 96.8%, 93.3%, 91.2%, and 91.2%, respectively. Actuarial freedom from graft coronary artery disease at 1, 5, and 10 years was 95.7%, 72.4%, and 53.0%, respectively. Actuarial freedom from graft coronary artery disease-related death or retransplantation at 1, 5, and 10 years were 99.5%, 93.7%, and 85.3%, respectively. CONCLUSION: These data suggested satisfactory long-term results of adult cardiac transplantation utilizing FK506.