Long-Term Beneficial Effect of Tacrolimus Conversion on Renal Transplant Recipients

Figures & data

Table 1. Patients' clinical characteristics

Total (N = 34)
Age (yrs)	44.4 ± 12.5a (16, 67)b
Sex (M/F)	26/8
Follow-up duration (yrs)	6.3 ± 3.7 (0.7, 14.2)
Dialysis duration (yrs)	2.2 ± 2.4 (0.04, 9.9)
FK duration (yrs)	3.0 ± 2.2 (0.6, 7.2)
Donor type (cadaveric/living)	31/3
Immunosuppressive agents
PC	6 (17.6%)
PCA	6 (17.6%)
PCM	22 (64.7%)
MP†† before conversion	21(61.8%)
HBV ( + )	5(14.7%)
HCV ( + )	7(20.6%)

^aMean ± standard deviation.

^bRange (minimum, maximum).

^*Duration on tacrolimus.

^†P: prednisolone; C: cyclosporine; A: azathioprim; M: mycophenolate mofetil.

^††Methylprednisolone.

^§Hepatitis B virus infection.

^∥Hepatitis C virus infection.

Table 2. Change in blood pressure and biochemical data after conversion

N = 34	CsA	Tacrolimus	p value
SBP (mmHg)	137.4 ± 2.4a	128.6 ± 12.4a	0.011
DBP (mmHg)	84.0 ± 1.8	70.2 ± 1.6	0.019
Cholesterol (mg/dL)	218.0 ± 10.5	198.7 ± 7.3	0.113
TG (mg/dL)	137.1 ± 11.3	148.2 ± 15.3	0.540
GPT (u/L)	31.1 ± 7.2	29.6 ± 5.4	0.766

^*Paired t-test was used.

^aMean ± SEM.

Table 3. Renal outcome after conversion of biopsy-proven patients

	Improved	Stabilized	Worsened	Graft loss
Acute rejection (N = 14)	5 (35.7%)	7 (50.0%)	2 (14.3%)	0 (0.0%)
Chronic allograft nephropathy (N = 9)	1 (11.1%)	3 (33.3%)	3 (33.3%)	2 (22.2%)
Acute rejection + chronic	0 (0.0%)	1 (20%)	1 (20.0%)	3 (60.0%)
allograft nephropathy (N = 5)
CsA nephrotoxicity (N = 6)	3 (50.0%)	2 (33.3%)	0 (0.0%)	1 (16.7%)

^*One patient lost his graft due to poor compliance to treatment.

Table 4. Comparison of common side effects: before vs. after conversion

Total (N = 34)	CsA	Tacrolimus	p value
Gingival hypertrophy	11 (32.4%)	2 (5.9%)	0.014
Hirsutism	16 (47.1%)	2 (5.9%)	0.0004
Tremor	6 (17.6%)	9 (26.5%)	0.559

Yates' correction for continuity was used.

Table 5. Renal outcome in terms of baseline serum creatinine

	Cr≧3 mg/dL (N = 11)	Cr < 3 mg/dL (N = 23)	p value
Improved + stable	8 (72.7%)	15 (65.2%)	1.0
Worsened + failure	3 (27.3%)	8 (34.8%)

Fisher's exact test was used.

Figure 1 Significant decrease in serum creatinine was observed after conversion of CsA to tacrolimus. (Wilcoxon' signed-rank test was used.)

Figure 2 Progressive improvement in GFR was observed after conversion. (Wilcoxon' signed-rank test was used.)