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

Michael R. Lucey, Manal F. Abdelmalek, Rosemarie Gagliardi, Darla Granger, Curtis Holt, Igal Kam, Goran Klintmalm, Alan Langnas, Kirti Shetty, Andreas Tzakis, E. Steve Woodle

Research output: Contribution to journalReview articlepeer-review

71 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1111-1119
Number of pages9
JournalAmerican Journal of Transplantation
Volume5
Issue number5
DOIs
StatePublished - May 2005

Keywords

  • Cardiovascular risk
  • Cyclosporine
  • Liver transplantation
  • Renal function
  • Tacrolimus

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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