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|Title:||Impact of tacrolimus versus cyclosporine on one-year renal transplant outcomes : a single-centre retrospective cohort study||Authors:||Ong, Pei Wen
Ho, Quan Yao
|Keywords:||Science::Medicine||Issue Date:||2020||Source:||Ong, P. W., Kee, T. & Ho, Q. Y. (2020). Impact of tacrolimus versus cyclosporine on one-year renal transplant outcomes : a single-centre retrospective cohort study. Proceedings of Singapore Healthcare, 29(4), 217-222. https://dx.doi.org/10.1177/2010105820957370||Journal:||Proceedings of Singapore Healthcare||Abstract:||Background: Calcineurin inhibitors are the cornerstone of maintenance immunosuppression after kidney transplant. While studies on predominantly Caucasian populations recommend tacrolimus over cyclosporine, the effects on Singapore’s local population remain unclear. Objectives: This study aimed to compare the impact of tacrolimus against cyclosporine on post-transplant outcomes in our local kidney transplant population. Methods: A single-centre retrospective chart review was conducted on ABO- and human leucocyte antigen (HLA)-compatible kidney transplantations between 1 January 2011 and 15 August 2018. Patients who received basiliximab induction, prednisolone, mycophenolate and either tacrolimus or cyclosporine were included and followed up for at least one year. Recipients of transplantations at other institutions or other immunosuppressive regimens were excluded. Patient and graft outcomes and adverse effects were collected. Results: Overall, 120 patients on tacrolimus and 49 on cyclosporine were included. Patients on tacrolimus were older. This group had more deceased donor transplants, a higher proportion with donor-specific antibodies (DSAs) present and more HLA mismatches. There were no differences in patient and graft survival, graft function and acute rejections at one year, despite adjusting for age, transplant type, presence of DSAs and total HLA mismatches. The tacrolimus group had more infectious admissions (odds ratio=0.27, 95% confidence interval 0.098–0.73, p=0.01) after adjusting for age, transplant type, HLA mismatches, presence of DSAs and acute rejections, with increased severity and more opportunistic infections. More patients on cyclosporine required a change to alternative immunosuppressants (p=0.003). Conclusion: Our study demonstrated comparable short-term post-transplant outcomes between cyclosporine and tacrolimus. Tacrolimus appears more tolerable but may be associated with infection risks.||URI:||https://hdl.handle.net/10356/148597||ISSN:||2010-1058||DOI:||10.1177/2010105820957370||Rights:||© 2020 The Author(s). Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).||Fulltext Permission:||open||Fulltext Availability:||With Fulltext|
|Appears in Collections:||LKCMedicine Journal Articles|
Updated on Jan 20, 2022
Updated on Jan 20, 2022
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