Volume 37, Issue 7, Pages 3025-3028 (September 2005)
Tacrolimus (FK506) Versus Cyclosporine
Microemulsion (Neoral) as Maintenance
Immunosuppression Therapy in Kidney
M.M. Abou-Jaoudea, R. Najmb, J. Shaheena, N. Nawfala, S. Abboudc, M. AlHabashM. Darwishe, A. Mulheme, A. Ojjehe, W.Y. Almawif
The effects of the calcineurin inhibitors tacrolimus (FK506) and cyclosporine (Neoral) on graft survival, function, and metabolic profile were evaluated in 69 patients receiving Neoral (group 1) and 54 patients receiving FK506 (group 2) for maintenance immunosuppression following kidney transplantation. Recipient and donor demographics and induction therapy were comparable, except for a higher number of sensitized patients in group 2 (n = 13). Acute rejection timing, severity, and infection rates and types were similar in both groups. During hospitalization, at 6 months, and at 1 year following transplantation, no significant differences were noted between groups in fasting glucose, serum cholesterol levels, triglyceride levels, or need for insulin or antihypertensive therapy. Mean serum creatinine levels on discharge (1.42 mg/dL ± 0.14 vs 1.68 mg/dL ± 0.3), at 1 month (1.45 mg/dL ± 0.1 vs 1.39 mg/dL ± 0.11), 3 months (1.46 mg/dL ± 0.09 vs 1.32 mg/dL ± 0.14), and 1 year (1.29 mg/dL ± 0.08 vs 1.19 mg/dL ± 0.09), but not at 6 months (1.42 ± 0.37 vs 1.10 ± 0.07; P
= .001), were comparable between groups. The 1-year patient and graft survival rates were 98.3% for group 1 and 94.5% for group 2. When evaluated for acute rejection, infection, and metabolic differences, we conclude that both tacrolimus and cyclosporine are effective and safe calcineurin inhibitors for short-term use in kidney transplantation. A similar study is proposed to evaluate the long-term effects of both agents.
Volume: 2 – Nummber: 2 – December 2004
TACROLIMUS (FK506) VERSUS CYCLOSPORIN A MICROEMULSION
(NEORAL) AS MAINTENANCE IMMUNOSUPPRESSION THERAPY IN KIDNEY
Abou-Jaoude MM, Najm R, Shaheen J, Nawfal N, Abboud S, Almawi W, AlHabash M, Darwish M,
Mulhem A, Ojjeh A
Beirut, Lebanon and Damascus, Syria Hospitals.
The aim of this study is to compare the effects of 2 calcineurin inhibitors on graft survival and
function and their metabolic profile following kidney transplantation.
We reviewed 2 groups of kidney transplant patients receiving NEORAL (Group I, 69 patients) or
FK506 (Group II, 54 patients) as maintenance Immunosupression done between December
1998 and June 2003. The recipient and donor demographics and induction therapy were
comparable in both groups except for more highly sensitized patients in group II (13 patients). Acute rejection (AR) rate, timing and severity were similar in both groups despite the more
highly sensitized patients in Group II. Infections rate and type were similar in both groups
(26.1% in Group I and 34% in Group II; P=N.S). No statistically significant differences were
noticed between the 2 groups concerning the FBS, the need for insulin therapy, the cholesterol
and triglycerides blood levels and the need for anti-hypertensive drugs at 6 months at 1 year
post transplantation despite lower pre transplant mean cholesterol blood level in group I
patients. The patient’s hospital stay was similar in both groups. The mean serum creatinine
levels upon discharge, at 1, 3 and 6 months and 1 year were: 1.42 +/- 0.14, 1.45 +/- 0.1,
1.46 +/- 0.09, 1.42 +/- 0.37 and 1.29 +/- 0.08 in Group I and 1.68 +/- 0.3, 1.39 +/- 0.11,
1.32 +/- 0.14, 1.1 +/- 0.07 and 1.19+/- 0.09 in Group II respectively. We found that lower
serum creatinine levels were observed in group II at 6 months (P = 0.001). The 1 year actuarial patient and graft survival were 98.3% in group I and 94.5% in group II (P = N.S.).
Both calcineurin inhibitors are effective and safe in KT concerning the AR and infection rates.
No metabolic differences were noticed in our studies on short term. The same study will be
continued to evaluate the long term effects of both drugs.
Copyright Baskent University 2003. Printed in Turkey. All Rights Reserved.
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