Tacrolimus in Delayed Graft Function in Cadaveric Renal Transplantation.
- Author:
Mee Sook LEE
1
;
Jai Won CHANG
;
Duck Jong HAN
;
Eun Sil YU
;
Won Seok YANG
;
Su Kil PARK
Author Information
1. Department of Internal Medicine, Jeongeup Asan Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Tacrolimus;
Acute tubular necrosis;
Delayed graft function;
Cadaveric renal transplantation;
Nephrotoxicity
- MeSH:
Antibodies;
Antilymphocyte Serum;
Aspergillosis;
Cadaver*;
Cyclosporine;
Delayed Graft Function*;
Graft Survival;
Humans;
Immunosuppression;
Kidney Transplantation*;
Muromonab-CD3;
Necrosis;
Nephrectomy;
Retrospective Studies;
Tacrolimus*;
Transplantation;
Transplants
- From:Korean Journal of Nephrology
2002;21(4):667-674
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: In the presence of anticipated or established acute tubular necrosis (ATN) immediately after cadaveric kidney transplantation, induction with monoclonal or polyclonal antibody is recommended in preparation of increased risk of acute rejection caused by ATN. Tacrolimus is a potent immunosuppressive agent than cyclosporine. In this study, we analyzed retrospectively the clinical outcome of patients who had taken tacrolimus as a replacement of cyclosporine in the period of delayed graft function(DGF) to determine the eligibility of tacrolimus instead of antilymphocyte antibody in this situation. METHODS: Between March 1, 1991 and August 31, 2000, DGF developed in eighteen first cadaveric renal transplant recipients in our center. During DGF period, twelve patients received tacrolimus based immunosuppression without OKT3. We reviewed the complete clinical course of the 12 patients. RESULTS: Among the 12 patients, 1 patient underwent graft nephrectomy at postoperative 27 days, because of poor renal function and concomitant aspergillosis infection. In the remaining 11 patients, however, for whom tacrolimus was maintained continuously without OKT3 therapy, renal function was recovered successfully. One acute rejection developed at postoperative 15 months. One patient died at postoperative 5 months with functioning graft. One-year graft survival rate was 83%. CONCLUSION: Tacrolimus could be used in replacement of cyclosporine for the prevention of acute rejection in DGF. This could provide a graft survival comparable to that by the monoclonal or polyclonal antibodies without the potential risk of life- threatening side effects in this situation.