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Primary Immunosuppression With Tacrolimus in Kidney Transplantation: Three-Year Follow-up in a Single Center

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Author(s)
H.C. KimE.A. HwangS.Y. HanS.B. ParkH.T. KimW.H. Cho
Keimyung Author(s)
Kim, Hyun ChulHwang, Eun AhHan, Seung YeupPark, Sung BaeKim, Hyoung TaeCho, Won Hyun
Department
Dept. of Internal Medicine (내과학)
Dept. of Surgery (외과학)
Journal Title
Transplantation Proceedings
Issued Date
2004
Volume
36
Issue
7
Abstract
Introduction
The 1-year results of the phase III US Multicenter Trial comparing tacrolimus- and cyclosporine (Sandimmun)-based immunosuppressive therapy in kidney transplantation revealed a significant reduction in the incidence and severity of acute rejection episodes among patients maintained on tacrolimus. This retrospective, nonrandomized, single-center study represented 3-year data for patient and graft survival and safety in the tacrolimus-treated patients.

Methods

Among 97 consecutive kidney transplant recipients 41 who received tacrolimus and 56 cyclosporine-based immunosuppression were followed for 3 years for patient and graft survivals and for the incidence of acute rejection episodes as well as serious adverse events.

Results

The 3-year patient and graft survival rates for tacrolimus and cyclosporine were similar (91.0% vs 90.2%, 96.5% vs 95.0%). However, the incidence of acute rejection episodes was significantly lower in the tacrolimus (17.1%) compared with the cyclosporine group (35.7%, P = .043). There was a higher incidence of headache, posttransplant diabetes, and alopecia reported in the tacrolimus group, whereas hypertension, hypercholesterolemia, and hirsutism were more frequent in the cyclosporine group. The incidences of hand tremor, hyperkalemia, and viral infections were comparable in both groups. Two patients in the tacrolimus group were converted to cyclosporine due to nephrotoxicity and posttransplant diabetes, respectively, whereas 12 patients in the cyclosporine group were converted to tacrolimus as rescue therapy for acute rejection (41.7%), gingival hyperplasia (33.3%), nephrotoxicity (8.3%), neurotoxicity (8.3%), and hirsutism (8.3%), respectively.

Conclusion

The 3-year results of tacrolimus treatment show excellent efficacy and safety in kidney transplantation. Due to different side-effect profiles, it is necessary to develop individualized immunosuppressive strategies in kidney transplant recipients.



The US randomized, comparative, multicenter study demonstrated that tacrolimus was equivalent to cyclosporine (Sandimmun, CyA) in 1-year patient and graft survivals among recipients of cadaveric renal transplants. However, the incidence and severity of acute rejection episodes were significantly lower in tacrolimus- compared with CyA-treated patients.1 This retrospective, nonrandomized, single-center study summarizes results of a 3-year follow-up.
Keimyung Author(s)(Kor)
김현철
황은아
한승엽
박성배
김형태
조원현
Publisher
School of Medicine
Citation
H.C. Kim et al. (2004). Primary Immunosuppression With Tacrolimus in Kidney Transplantation: Three-Year Follow-up in a Single Center. Transplantation Proceedings, 36(7), 2082–2083. doi: 10.1016/j.transproceed.2004.08.006
Type
Article
ISSN
0041-1345
Source
https://www.sciencedirect.com/science/article/pii/S0041134504008619?via%3Dihub
DOI
10.1016/j.transproceed.2004.08.006
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34718
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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