Comparison of tacrolimus with a cyclosporine microemulsion for immunosuppressive therapy in kidney transplantation

Ekmekcioglu, Ozan; Turkan, Sadi; Yıldız, Şener; Güneş, Zeki

doi:10.5152/tud.2013.004

Cited by 11 publications

(16 citation statements)

References 30 publications

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“…More patients on cyclosporine required crossover to tacrolimus in our study, mainly due to graft rejection and unpredictable drug levels, similar to findings by Vincenti et al 29 Tacrolimus may also be more tolerable 30 with fewer cosmetic side effects, 31 and some adverse effects (e.g. tremors) may be reversible with a dose reduction.…”

Section: Tacrolimus (N=120)supporting

confidence: 88%

Impact of tacrolimus versus cyclosporine on one-year renal transplant outcomes: A single-centre retrospective cohort study

Ong

Kee

2020

Proceedings of Singapore Healthcare

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Background: Calcineurin inhibitors are the cornerstone of maintenance immunosuppression after kidney transplant. While studies on predominantly Caucasian populations recommend tacrolimus over cyclosporine, the effects on Singapore’s local population remain unclear. Objectives: This study aimed to compare the impact of tacrolimus against cyclosporine on post-transplant outcomes in our local kidney transplant population. Methods: A single-centre retrospective chart review was conducted on ABO- and human leucocyte antigen (HLA)-compatible kidney transplantations between 1 January 2011 and 15 August 2018. Patients who received basiliximab induction, prednisolone, mycophenolate and either tacrolimus or cyclosporine were included and followed up for at least one year. Recipients of transplantations at other institutions or other immunosuppressive regimens were excluded. Patient and graft outcomes and adverse effects were collected. Results: Overall, 120 patients on tacrolimus and 49 on cyclosporine were included. Patients on tacrolimus were older. This group had more deceased donor transplants, a higher proportion with donor-specific antibodies (DSAs) present and more HLA mismatches. There were no differences in patient and graft survival, graft function and acute rejections at one year, despite adjusting for age, transplant type, presence of DSAs and total HLA mismatches. The tacrolimus group had more infectious admissions (odds ratio=0.27, 95% confidence interval 0.098–0.73, p=0.01) after adjusting for age, transplant type, HLA mismatches, presence of DSAs and acute rejections, with increased severity and more opportunistic infections. More patients on cyclosporine required a change to alternative immunosuppressants (p=0.003). Conclusion: Our study demonstrated comparable short-term post-transplant outcomes between cyclosporine and tacrolimus. Tacrolimus appears more tolerable but may be associated with infection risks.

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Section: Tacrolimus (N=120)supporting

confidence: 88%

Impact of tacrolimus versus cyclosporine on one-year renal transplant outcomes: A single-centre retrospective cohort study

Ong

Kee

2020

Proceedings of Singapore Healthcare

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“…[9] Following renal transplantation a marked increase in the risk of some cancers develops, and increasing evidence supports the role of immune suppression in the development of this increased risk. [10] Risk of developing urothelial…”

Section: Discussionmentioning

confidence: 99%

Urothelial carcinoma of the allograft kidney developed in a renal transplant patient

Gökçe

Kocaay

Aktürk

et al. 2016

Turkish Journal of Urology

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“…Tacrolimus is a calcineurin inhibitor that is required for T-cell receptor induction of interleukin-2 (IL-2) and for T cell proliferation. It has a superior safety profile compared with the earlier calcineurin inhibitor, cyclosporine [ 12 , 13 ]. At the end of 1990s, an Edmonton group developed an islet transplantation protocol using the steroid-free immunosuppressive agents sirolimus, daclizumab and tacrolimus, and reported on seven patients with severe type 1 diabetes who were all able to function without insulin treatment with no episodes of hypoglycemic coma [ 14 ].…”

Section: Islet Transplantation and Its Obstaclesmentioning

confidence: 99%

The Spleen as an Optimal Site for Islet Transplantation and a Source of Mesenchymal Stem Cells

Sakata

Yoshimatsu

Kodama

2018

IJMS

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This review demonstrates the unique potential of the spleen as an optimal site for islet transplantation and as a source of mesenchymal stem cells. Islet transplantation is a cellular replacement therapy used to treat severe diabetes mellitus; however, its clinical outcome is currently unsatisfactory. Selection of the most appropriate transplantation site is a major factor affecting the clinical success of this therapy. The spleen has long been studied as a candidate site for islet transplantation. Its advantages include physiological insulin drainage and regulation of immunity, and it has recently also been shown to contribute to the regeneration of transplanted islets. However, the efficacy of transplantation in the spleen is lower than that of intraportal transplantation, which is the current representative method of clinical islet transplantation. Safer and more effective methods of islet transplantation need to be established to allow the spleen to be used for clinical transplantation. The spleen is also of interest as a mesenchymal stem cell reservoir. Splenic mesenchymal stem cells contribute to the repair of damaged tissue, and their infusion may thus be a promising therapy for autoimmune diseases, including type 1 diabetes mellitus and Sjogren’s syndrome.

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Comparison of tacrolimus with a cyclosporine microemulsion for immunosuppressive therapy in kidney transplantation

Cited by 11 publications

References 30 publications

Impact of tacrolimus versus cyclosporine on one-year renal transplant outcomes: A single-centre retrospective cohort study

Impact of tacrolimus versus cyclosporine on one-year renal transplant outcomes: A single-centre retrospective cohort study

Urothelial carcinoma of the allograft kidney developed in a renal transplant patient

The Spleen as an Optimal Site for Islet Transplantation and a Source of Mesenchymal Stem Cells

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