Early conversion to tacrolimus vs cyclosporine continuation in normally functioning kidney allograft: a single-center study

Document Type: Research article

Authors

1 Department of Clinical Pharmacy, Faculty of pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

2 Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

3 Urology Research Center, Sina Hospital, Tehran University of Medical sciences, Tehran, Iran.

4 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.

Abstract

This study evaluated the effectiveness of early pre-emptive conversion from cyclosporine to tacrolimus in kidney transplantation patients with normal graft function and in the absence of adverse effects of the initial cyclosporine. A historical cohort study of 166 patients who received deceased-donor kidney transplant between 2011 to 2017 was conducted. All the patients had been treated with cyclosporine (Sandimmune®) during their immediate post-transplantation period. At the time of hospital discharge, patients were divided into 2 groups: patients with continued cyclosporine (Sandimmune®) treatment (n= 125) and patients whose treatments converted from cyclosporine to tacrolimus (Prograf®) at discharge (n= 41).
The 1-year graft function (p = 0.074), acute rejection (p = 0.566) and graft loss (p = 0.566) were not significantly different between two groups. Patients on tacrolimus had lower levels of cholesterol (p = 0.002) and diastolic blood pressure (p = 0.015). The long-term follow-up showed no significantly difference in graft loss (p = 0.566). Patients received tacrolimus had higher all-causes mortality within the first year posttransplantation (p = 0.002) as well as long-term follow-up (p = 0.001).
The continuation of initial cyclosporine might be a good option when the graft function is acceptable and the adverse effects are absent.

Graphical Abstract

Early conversion to tacrolimus vs cyclosporine continuation in normally functioning kidney allograft: a single-center study

Keywords