J Korean Soc Transplant.  2014 Jun;28(2):69-77. 10.4285/jkstn.2014.28.2.69.

Actual 10-year Outcomes of Tacrolimus/MMF Compared with Cyclosporin/MMF in Kidney Transplantation

• Kim Y
• Park S
• Kim H
• Han S

• KMID: 2202533
• DOI: http://doi.org/10.4285/jkstn.2014.28.2.69

Abstract

BACKGROUND
Kidney transplantation is the most effective treatment in patients with chronic kidney disease. Recently, the survival rate of kidney allografts has been markedly increased by the development of immunosuppressants. According to research reports published in Symphony in 2007 and 2009, low dose tacrolimus/mycophenolate mofetil (MMF) showed better results than cyclosporin/MMF in renal function and rejection.
METHODS
We compared patient survival rate, graft survival rate, incidence of rejection, and metabolic complications in two groups of patients who received immunosuppressants with either tacrolimus/MMF/steroid or cyclosporin/MMF/steroid. All patients underwent kidney transplants at Keimyung University Dongsan Medical Center between January 1997 and December 2003 with follow-up over 10 years.
RESULTS
A total of 180 patients were included in the research (117 patients were treated with tacrolimus/MMF/steroid and 63 patients with cyclosporin/MMF/steroid). The incidence rate of acute rejection was higher in the cyclosporin/MMF/steroid group; however, the difference was not statistically significant. In the case of metabolic complications, new onset diabetes after transplantation was more frequent in the tacrolimus/MMF/steroid group. The cyclosporin/MMF/steroid group appeared to have a higher rate of hypertension and hyperlipidemia.
CONCLUSIONS
Overall, no significant differences in patient and graft survival rate were observed between the two groups.

Keyword

Kidney transplantation; Cyclosporin; Tacrolimus

MeSH Terms

Allografts
Cyclosporine
Follow-Up Studies
Graft Survival
Humans
Hyperlipidemias
Hypertension
Immunosuppressive Agents
Incidence
Kidney
Kidney Transplantation*
Renal Insufficiency, Chronic
Research Report
Survival Rate
Tacrolimus
Cyclosporine
Immunosuppressive Agents
Tacrolimus

Figure

• 

  Fig. 1. The flow diagram shows patient selection process, with inclusion and exclusion criteria. Abbreviations: Tac, tacrolimus; MMF, mycophenolate mofetil; Cyc, cyclosporine; f/u, follow-up; KT, kidney transplantation.

• 

  Fig. 2. The annual changes of donor type (A) and immunosuppressive agent (B) in kidney transplantation from 1997 to 2003. Abbreviation: MMF, mycophenolate mofetil.

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  Fig. 3. Patient (A) and graft (B) survival of kidney transplantation according to maintenance immunosuppressant. Abbreviations: MMF, mycophenolate mofetil; NS, not significant.

Reference

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