Clinical study of treatment conversion from CsA to tacrolimus after kidney transplantation due to side effects of CsA
- VernacularTitle:肾移植术后他克莫司替换环孢素A的临床观察
- Author:
Lixin YU
;
Bing YAO
;
Chuanfu DU
;
Al ET
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Tacrolimus;
Cyclosporine
- From:
Chinese Journal of Urology
2001;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical outcomes of treatment conversion from cyclosporine A (CsA) based immunosuppression to a new agent tacrolimus (FK506) after kidney tansplantation due to the side effects of CsA. Methods Forty eight cases of kidney transplantation who were diagnosed having CsA hepatoxicity,10 cases having gingival overgrowth,16 cases having hirsuties,and 13 cases having hyperlipidemia were treated with tacrolimus (FK506) in place of CsA.The initial dose of tacrolimus was administered according to the patient's body weight,liver function and time of post operation.The dosage of tacrolimus was adjusted according to its trough level,and the blood levels of tacrolimus were sustained to 8～10 ?g/L within 6 months after operation,6～8 ?g/L within 1 year and 4～6 ?g/L 1 year later.The liver function, renal function,serum lipids level,whole blood FK506 trough concentration,immunosuppressive index and clinical symptoms were closely monitored. Results In 47 of 48 patients who had CsA hepatoxicity and then were treated with FK506 in place of CsA,the liver function became normal 10～48 days later.Only one patient died of liver failure after treatment switch to FK506.All of the 10 patients experienced significant resolution of their gingival enlargement within the time period studied,however only 6 of them had complete regression.All the 16 recipients with hirsuties benefited from replacing CsA with tacrolimus,and were cured after the switch.Lipids levels decreased significantly in the 13 recipients with hyperlipidemia after conversion to tacrolimus. Creatinine levels remained stable and no acute rejection was observed in the study. Conclusions Treatment conversion from CsA to tacrolimus is safe and effective in recipients with hepatic dysfunction,hyperlipidemia or hirsuteness,gingival overgrowth after renal transplantation.The conversion from CsA based immunosuppression to tacrolimus has less side effects and no increase in rejection rate in renal transplant recipients.
