Renal Function in Patients With Cadaveric Kidney Transplants Treated With Tacrolimus or Cyclosporine

• Published in: Transplantation proceedings 2007-09, Vol.39 (7), p.2167-2169
• Main Authors: Gonzalez Molina, M, Morales, J.M, Marcen, R, Campistol, J.M, Oppenheimer, F, Serón, D, Gil-Vernet, S, Capdevila, L, Andrés, A, Lampreave, I, Del Castillo, D, Cabello, M, Burgos, D, Valdés, F, Anaya, F, Escuín, F, Arias, M, Pallardó, L, Bustamante, J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Cadaver; Cyclosporine - therapeutic use; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Immunosuppressive Agents - therapeutic use; Kidney Function Tests; Kidney Transplantation - immunology; Kidney Transplantation - physiology; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tacrolimus - therapeutic use; Tissue Donors; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2007.07.043

Abstract Introduction Renal function predicts graft survival in kidney transplant patients. This study compared the 2-year evolution of renal function in patients treated with cyclosporine or tacrolimus in combination with mycophenolate mofetil (MMF) and prednisone. Methods We studied 1558 cadaveric renal transplant recipients from 14 Spanish hospitals between January 2000 and December 2002. Of these, 1168 were treated with tacrolimus and 390 with cyclosporine. The primary efficacy endpoint was long-term renal function. Renal function was measured by serum creatinine and glomerular filtration rate (GFR) by creatinine clearance calculated from the Cockcroft-Gault formula. This report summarizes the 2-year results. Results At 24 months the tacrolimus group showed significantly better serum creatinine (1.5 ± 0.7 vs 1.8 ± 0.8 mg/dL, P < .001) and GFR (60.5 ± 20.9 mL/min vs 47.9 ± 10.0, P < .001) than the cyclosporine group. Additionally, recipients with ideal graft donors (23.5 ± 2.8 vs 24.0 ± 2.9 years) had a better serum creatinine at 2 years (1.23 ± 0.2 vs 1.5 ± 0.4 mg/dL, P < .05). Multivariate analysis showed that tacrolimus was an independent factor associated with better renal function: odds ratio 1.6, 95% confidence interval (1.2 to 2.2), P < .001. Conclusions Patients with a renal transplant treated with tacrolimus in combination with MMF and prednisone displayed better renal function at 2 years than those who received cyclosporine.