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©The Author(s) 2016.
World J Transplant. Dec 24, 2016; 6(4): 697-702
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.697
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.697
Table 1 Characteristics of patients in tacrolimus and cyclosporine group n (%)
Parameter | Cyclosporine n = 640 | Tacrolimus n = 1195 | P-value |
Mean recipient age (yr) | 49 ± 12 | 50 ± 13 | 0.059 |
Race | 0.96 | ||
Non-African American | 281 (44) | 526 (44) | |
African-American | 359 (56) | 669 (56) | |
Sex | 0.78 | ||
Male | 371 (58) | 693 (58) | |
Female | 269 (42) | 502 (42) | |
BMI | 26 ± 7 | 28 ± 5 | 0.462 |
Etiology of kidney disease | |||
DM | 172 (26.9) | 375 (31.4) | 0.044 |
HTN | 317 (49.5) | 559 (46.8) | 0.26 |
FSGS | 36 (5.6) | 78 (7.3) | 0.177 |
IgA nephropathy | 24 (3.8) | 34 (2.8) | 0.291 |
Polycystic kidney | 63 (9.8) | 89 (7.4) | 0.076 |
History of DM | 186 (29) | 394 (33) | 0.092 |
History of HTN | 595 (93) | 1135 (95) | 0.122 |
History of heart disease | 134 (21) | 227 (19) | 0.38 |
Years on dialysis | 3 ± 2.4 | 3 ± 2.9 | 0.01 |
PRA | 5% | 17% | < 0.010 |
Preemptive transplant | 122 (19) | 239 (20) | 0.49 |
Living donor transplant | 122 (19) | 179 (15) | 0.27 |
CIT (h) | 13 ± 9 | 16 ± 9 | 0.621 |
Mean donor age (yr) | 31 ± 18 | 36 ± 16 | < 0.010 |
KDRI | 0.9 ± 0.6 | 1.3 ± 0.4 | < 0.010 |
African-American donor | 122 (19) | 203 (17) | 0.27 |
Induction therapy | < 0.010 | ||
Cytolytic agents | 70 (11) | 550 (46) | |
IL-2 receptor antagonist | 570 (89) | 645 (54) |
Table 2 Clinical outcomes
Parameter | Tacrolimus n = 1195 | Cyclosporine n = 640 | P-value |
Mean glomerular filtration rate | 56 ± 19 | 46 ± 17 | 0.09 |
Delayed graft function n (%) | 179 (15) | 115 (18) | 0.049 |
Acute rejection (biopsy proven) n (%) | 167 (14) | 154 (24) | < 0.010 |
Three years graft survival | 88% | 79% | < 0.010 |
Five years graft survival | 84% | 70% | < 0.010 |
Table 3 Multivariate analysis of factors associated with acute rejection
Variable | Hazard ratio | 95%CI | P-value |
CNI tacrolimus | 0.6 | 0.45-0.79 | < 0.001 |
Retransplant | 1.43 | 0.91-2.24 | 0.123 |
PRA | 1 | 0.99-1.00 | 0.529 |
Cytolytic induction | 0.5 | 0.36-0.69 | < 0.001 |
Table 4 Multivariate analysis of factors associated with graft loss
Variable | Hazard ratio | 95%CI | P-value |
CNI tacrolimus | 0.74 | 0.58-0.94 | 0.012 |
History of DM | 1.41 | 1.13-1.76 | 0.002 |
History of HTN | 0.56 | 0.34-0.94 | 0.029 |
Delayed graft function | 2.1 | 1.66-2.66 | < 0.001 |
Acute rejection | 1.59 | 1.26-2.01 | < 0.001 |
Table 5 Graft loss n (%)
Parameter | Tacrolimus n = 106 | Cyclosporine n = 123 | P-value |
Death with functioning graft | 61 (58) | 66 (54) | 0.55 |
Cause of death | 0.85 | ||
Cardiovascular disease | 19 (18) | 19 (15) | |
Infections | 10 (9) | 9 (7) | |
Malignancy | 10 (9) | 9 (7) | |
Others | 33 (31) | 41 (33) | |
Causes of graft loss | 0.44 | ||
Chronic allograft nephropathy | 18 (17) | 29 (24) | |
Acute rejection | 14 (13) | 11 (9) | |
Acute on chronic rejection | 8 (8) | 13 (11) | |
Recurrent disease | 1 (1) | 1 (1) | |
Death | 63 (59) | 68 (55) | |
Component of non- adherence | 15 (14) | 20 (16) | 0.65 |
Component of underimmunosuppression | 21 (20) | 25 (20) | 0.92 |
- Citation: Kamel M, Kadian M, Srinivas T, Taber D, Posadas Salas MA. Tacrolimus confers lower acute rejection rates and better renal allograft survival compared to cyclosporine. World J Transplant 2016; 6(4): 697-702
- URL: https://www.wjgnet.com/2220-3230/full/v6/i4/697.htm
- DOI: https://dx.doi.org/10.5500/wjt.v6.i4.697