A comparison of long-term effect and safety between tacrolimus and cyclosporine in cadaveric renal transplantation

Objective To compare the long-term effect and safety between tacrolimus (FK506) and cyclosporine (CsA) in patients receiving cadaveric renal transplantation. Method A total of 210 patients were randomized to FK506 and CsA after cadaveric renal transplantation, and were followed up for 12-32 months for the variation of trough concentration in whole blood, the incidence of acute rejection and chronic rejection, one-year survival rate of patient/graft, variation of creatinine level, impairment of liver function and glucose metabolism and lipid metabolism, incidence of infection, and side effects. Results The variation of trough concentration of FK506 was similar to CsA. The incidence of acute rejection was significantly lower in FK506 group than in CsA group ( 16.3 % vs 33.0 % , P 0.05 ). The incidence of chronic rejection was significantly lower in FK506 group than in CsA group ( 4.7 % vs 13.3 % , P 0.05 ). There was no significant difference in one-year survival rate of the patient/graft between FK506 group and CsA group ( 97.7 % / 96.5 % vs 96.7 % / 93.6 % , P 0.05 ). The incidence of impaired liver function and impaired lipid metabolism and gingivitis and creatinine level three months after transplantation were significantly lower in FK506 group than in CsA group ( P 0.05 ). The incidence of impaired glucose metabolism and tremor was significantly higher in FK506 group than in CsA group ( P 0.05 ). Conclusion FK506 is more effective than CsA in preventing acute and chronic rejection, and can significantly reduce the incidence in impairment of liver function and lipid metabolism and gingivitis, but it can increase the incidence in impairment of glucose metabolism and tremor.