A comparison of tacrolimus and cyclosporine in liver transplantation: Effects on renal function and cardiovascular risk status

被引:69
作者
Lucey, MR [1 ]
Abdelmalek, MF
Gagliardi, R
Granger, D
Holt, C
Kam, I
Klintmalm, G
Langnas, A
Shetty, K
Tzakis, A
Woodle, ES
机构
[1] Univ Wisconsin, Sch Med, Madison, WI USA
[2] Univ Florida, Gainesville, FL USA
[3] Mt Sinai Med Ctr, New York, NY 10029 USA
[4] Univ Louisville, Louisville, KY 40292 USA
[5] Univ Calif Los Angeles, Med Ctr, Los Angeles, CA 90024 USA
[6] Univ Colorado, Hlth Sci Ctr, Denver, CO USA
[7] Baylor Univ, Med Ctr, Dallas, TX USA
[8] Univ Nebraska, Med Ctr, Omaha, NE USA
[9] Hosp Univ Penn, Philadelphia, PA 19104 USA
[10] Univ Miami, Sch Med, Miami, FL USA
[11] Univ Cincinnati, Coll Med, Cincinnati, OH USA
关键词
cardiovascular risk; cyclosporine; liver transplantation; renal function; tacrolimus;
D O I
10.1111/j.1600-6143.2005.00808.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
A retrospective chart review of 1065 consecutive liver allograft recipients in 11 centers from January 1997 to September 1998 was performed. Patients were followed for 3 years or until graft loss. Patients received either tacrolimus (n = 594), cyclosporine (n = 450) or no calcineurin inhibitor (n = 21). Model for end-stage liver disease (MELD) scores at time of transplant were similar between the two groups. During follow-up, more patients switched from cyclosporine to tacrolimus (26.7%) than from tacrolimus to cyclosporine (12.8%; p < 0.0001). Patient and graft survival were equivalent. Corticosteroid use was more common in cyclosporine-treated patients (p < 0.00001). Patients receiving tacrolimus experienced lower serum creatinine levels at months 3 through 36 (p < 0.0001). Systolic blood pressure was lower in patients receiving tacrolimus (p < 0.001) despite a reduced requirement for anti-hypertensive agents (p < 0.0001). In addition, tacrolimus was associated with lower total cholesterol and triglyceride levels for months 3 through 24 and 3 through 12, respectively (p < 0.01), despite a reduced requirement for anti-hyperlipidemic agents. The incidence of new-onset diabetes mellitus was similar in both groups. While both calcineurin inhibitors were associated with excellent patient and graft survival, renal function, blood pressure and serum lipid levels were significantly better with tacrolimus treatment.
引用
收藏
页码:1111 / 1119
页数:9
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