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Kidney transplantation is the optimum treatment for most patients with end-stage renal disease. Calcineurin inhibitors (CNIs), cyclosporine and tacrolimus, are one of the three major components of immunosuppressive therapy of kidney transplantation. Our aims were to evaluate and compare the early- and long-term graft survival in kidney transplant recipients who were receiving either of these two CNIs.
This retrospective observational study included all live-related kidney transplant recipients, who underwent surgery in BIRDEM General Hospital, Dhaka, Bangladesh from November 2004 to December 2022.A questionnaire was formed and data were collected from the hospital records. Total 148 live-related kidney transplant recipients were included in the study and patients were divided in group 1 (patients on cyclosporine) and group 2 (patients on tacrolimus). We retrospectively evaluated patients’ clinical and laboratory findings.
Patients receiving tecrolimus showed almost similar renal function as cyclosporine receiving patients in early post-operative period; serum creatinine was 1.40± 1.04 versus 1.50± 1.21 mg/dL (p = 0.598) but they required less time for serum creatinine to become normal (4.02± 2.95 versus 5.86± 9.83 days, p=0.092) and less duration of post-transplant hospital stay (12.22± 2.16 versus 17.77± 18.01 days, p = 0.003). Acute rejection was more in group 1 than group 2 (15.1% versus 8.5%, p = 0.014). One- and five-year graft survivals for cyclosporine group was 92.0% and 83.3% and for tecrolimus group was 96.2% and 89.2% respectively (p value were 0.276 and 0.306 respectively).
Tacrolimus is relatively favorable to cyclosporine in preventing acute allograft rejection with shorter hospital stay and better immediate-and long-term post-transplant graft function.