Document Type: Research article
Department of Clinical Pharmacy, Faculty of pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Urology Research Center, Sina Hospital, Tehran University of Medical sciences, Tehran, Iran.
Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran.
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.