Comparative Analysis of Complications in Different Combinations of Immunosuppressive Therapy After Kidney Transplantation

Abstract

In the length of time, a wide variety of drug combinations emerged in the management of post-transplantation therapy in order to improve the survival of the recipient and graft. However, the efficacy and safety of the applied combinations regarding the rejection and other complications are continuing to be the subject of research. In our study, our aim is to compare the effects of various combinations, namely cyclosporine with mycophenolate mofetil/mofetil mycophenolic acid with prednisolone and tacrolimus with mycophenolate mofetil/mofetil mycophenolic acid with prednisolone in a length of time. Methods. A total of 204 patients included into the study who received post-renal transplantation treatment in Scientific-Research Institute of Heart Surgery and Organs Transplantation and followed-up over a 10-year period. The estimated survival probabilities in the study were determined by the Kaplan-Meier method; whereas intragroup comparisons were evaluated by Log-rang, Breslow, and Tarone-Ware tests. Complications occurred in patients with combinations were analyzed by Chi-square and its alternatives. Hazard risk factors were tested by Cox regression analysis. Results. Of these 204 patients, 36 received Cyclosporin combination (CCG) and 168 Tacrolimus combination (TCG). The estimated life expectancy of the patients of TCG was significantly longer than the CCG ones. Furthermore, gender and age did not have a significant effect on survival depending on time, however, gender and age-related hazard factor showed a significant difference in the groups. It was determined that chronic rejection was significantly different in patients who used tacrolimus combinations, the difference was close to the significant value in acute rejection analysis. Other adverse events, namely, infection, tumour and organ damage were statistically less common in the patient group treated with tacrolimus combinations. Conclusion. In general, TCG showed better results in contrast to CCG.