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• W2079040238 abstract "D uring the last 10 years, there have been several new medications added to the immunosuppressive armamentarium, resulting in a progressive increase in kidney half-life with each transplant year. The goal of this study was to compare the effect of 2 calcineurin inhibitors, tacrolimus (TAC) and cyclosporine (CsA), on graft loss, patient death, acute rejection, and serum creatinine level. All adult kidney transplants reported to the United Network for Organ Sharing/Organ Procurement and Transplantation Network (UNOS/OPTN) from 1995-2000, including 39,238 cadaveric recipients and 19,896 living donor recipients, were analyzed by discharge immunosuppression (CsA, n 46,128; TAC, n 13,026). Recipient and donor demographics, transplant (immunologic and nonimmunologic) and posttransplant variables such as delayed graft function, use of mycophenolate mofetil (MMF) versus azathioprine, and transplant year were used in the logistic regression model to calculate the odds ratio. The impact of TAC over CsA was assessed for various short-term end points at 1 year, including graft loss, patient death, acute rejection, serum creatinine level 1.5 mg/dL, and the composite end point (occurrence of at least 1 of the 1-year end points). In the TAC-based regimen group, there was a higher proportion of recipients with induction therapy (45% vs 40%), panel reactive antibody 10% (26% vs 11%), and previous transplant (20% vs 10%). With each transplant year, there was an increase in the number of patients receiving TAC. After we corrected for various variables, the odds ratios for short-term end points (graft loss, acute rejection, serum creatinine level 1.5 mg/dL, and composite end point) were lower with TAC compared with CsA therapy, as shown in Table 1. Other variables such as donor and recipient age and race, panel reactive antibody, delayed graft function, retransplantation, use of MMF, and transplant year were also significant. The 1-, 3-, and 5-year unadjusted actuarial graft survival rates for cadaveric recipients with TAC-based regimens were 91.8%, 81.1%, and 69.8%, respectively. The corresponding values for CsA-based therapy were 90.3%, 79.9%, and 67.5%, respectively (P .0001). Conclusion: The use of TAC-based regimens was associated with a decrease in 1-year end points such as graft loss, acute rejection, creatinine level 1.5 mg/dL, and 1-year composite end point. This effect was independent of other risk variables such as transplant year, panel reactive antibody, delayed graft function, and MMF use. From the Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI; and United Network for Organ Sharing, Richmond, VA. © 2003 Elsevier Inc. All rights reserved. 0955-470X/03/1704-0000$30.00/0 doi:10.1016/j.trre.2003.10.023 Table 1. Odds Ratio for End Points With TAC Compared With CsA Therapy" @default.
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• W2079040238 date "2003-10-01" @default.
• W2079040238 modified "2023-09-24" @default.
• W2079040238 title "Study 2: short-term benefit of tacrolimus versus cyclosporine therapy after renal transplantation: an analysis of United Network for Organ Sharing/Organ Procurement and Transplantation Network database" @default.
• W2079040238 doi "https://doi.org/10.1016/j.trre.2003.10.023" @default.
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