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ISSN 2007-6800 (Print)

2014, Number 3

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Rev Mex Traspl 2014; 3 (3)

Does the use of tacrolimus have real advantages over cyclosporine in renal transplant recipients with high metabolic risk? Comparative study of a cohort

González-Parra C, Espinoza E, Marino-Vázquez LA, Valdez-Ortiz R, Alberú J, Correa-Rotter R, Morales-Buenrostro LE

Language: Spanish
References: 20
Page: 78-85
PDF size: 306.46 Kb.


ABSTRACT

Introduction: Tacro has proven to be superior to CsA in preventing acute rejection. Additionally, it offers a better metabolic and cardiovascular profile. Objectives: To analyze if tacro use maintains its superiority in efficacy for the prevention of acute rejection, and its metabolic advantages in a high-metabolic-risk population like the Mexican one. Methods: We compared 50 kidney transplant recipients (KTR) taking tacro with 50 KTR using CsA. They were paired by donor and recipient age, haplotypes shared, transplant number, etiology of the kidney disease, donor type and immunosuppression used. The evaluated outcomes were acute rejection, graft and patient survival, graft loss and death causes. Additionally, we registered the graft function (SCr and eGFR), blood pressure, body mass index, serum levels for lipids and uric acid, on months 1, 3, 6 and yearly for 5 years. Chi-square test was used for categorical variables and Student-t test or Mann-Whitney U test for continuous variables. Results: Acute rejection was similar in both groups (5 each). Also, chronic rejection with or without fibrosis and tubular atrophy was similar (22 each group). There were two deaths by group (hemorrhagic cerebrovascular event and CMV pneumonia for the tacro group versus acute myocardial infarct and pneumonia for the CsA group. One and three graft loses occurred in tacro and CsA, respectively. A trend was observed to better graft function and better metabolic profile in the tacro group. Conclusions: Tacro use offers a better metabolic profile, which is especially important in populations with high risk for metabolic diseases like the Mexican one. Tacro was not better in acute rejection prevention or graft and patient survival.


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