신장 이식에서 일차 면역억제제로서 Tacrolimus와 Cyclosporine의 비교

Abstract

Purpose: The calcineurin inhibitors, tacrolimus and cyclosporine, have been used as primary immunosuppressant in renal transplantation. Tacrolimus has b^n shown to be an effective alternative to cyclosporine for the prevention of acute rejection but the two drugs are different in side-effect profile. This retrospective study compares the efficacy and safety of tacrolimus-based versus cyclosporine-based immunosuppression in patients receiving kidney transplantation. Methods: There were 177 consecutive recipients of kidney graft; 90 received cyclosporine-based irnmunosuppresston therapy, and 87 received tacrotimus-based immunosuppression. Graft and patient survival rate, incidence of acute rejection and side effects were compared. Results: The 3-year graft survival rate of cyclosporine and tacrolimus was similar (93.0% vs. 91.4%). The incidence of acute rejection was significantly less in the tacrolimus group compared with the cyclosporine group (10.3% vs. 31.1%, PC0.05). Incidence of impaired renal function, gastrointestinal disorder, tremor， hypertension and hyperkalemia were comparable in both treatment groups. Higher incidence of posttransplant diabetes, allopeciat abdominal pain and headache was reported in the tacrolimus group, whereas that of hypercholesterolmeia, hirsutism, and gum hyperplasia was more frequent with cyclosporine group. Conclusion: Tacrolimus is as effective as cyclosporine in patient and graft survival in kidney transplantation. Due to different side-effect profiles, it is needed to develop individualized immunosuppressive strategies in renal transplant recipients.