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A Comparison of Tacrolimus and Cyclosporine in Liver Transplantation: Effects on Renal Function and Cardiovascular Risk Status
Author(s) -
Lucey Michael R.,
Abdelmalek Manal F.,
Gagliardi Rosemarie,
Granger Darla,
Holt Curtis,
Kam Igal,
Klintmalm Goran,
Langnas Alan,
Shetty Kirti,
Tzakis Andreas,
Woodle E. Steve
Publication year - 2005
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2005.00808.x
Subject(s) - tacrolimus , medicine , calcineurin , liver transplantation , renal function , gastroenterology , transplantation , urology , ciclosporin , creatinine , blood pressure , diabetes mellitus , liver function , surgery , endocrinology
A retrospective chart review of 1065 consecutive liver allograft recipients in 11 centers from January 1997 to September 1998 was performed. Patients were followed for 3 years or until graft loss. Patients received either tacrolimus (n = 594), cyclosporine (n = 450) or no calcineurin inhibitor (n = 21). Model for end‐stage liver disease (MELD) scores at time of transplant were similar between the two groups. During follow‐up, more patients switched from cyclosporine to tacrolimus (26.7%) than from tacrolimus to cyclosporine (12.8%; p < 0.0001). Patient and graft survival were equivalent. Corticosteroid use was more common in cyclosporine‐treated patients (p < 0.00001). Patients receiving tacrolimus experienced lower serum creatinine levels at months 3 through 36 (p < 0.0001). Systolic blood pressure was lower in patients receiving tacrolimus (p < 0.001) despite a reduced requirement for anti‐hypertensive agents (p < 0.0001). In addition, tacrolimus was associated with lower total cholesterol and triglyceride levels for months 3 through 24 and 3 through 12, respectively (p < 0.01), despite a reduced requirement for anti‐hyperlipidemic agents. The incidence of new‐onset diabetes mellitus was similar in both groups. While both calcineurin inhibitors were associated with excellent patient and graft survival, renal function, blood pressure and serum lipid levels were significantly better with tacrolimus treatment.