TACROLIMUS VERSUS CYCLOSPORINE IN LOW IMMUNOLOGICAL RISK PATIENTS AFTER KIDNEY TRANSPLANTATION INDUCTED BY ANTI-THYMOCYTE GLOBULIN

Volume 12 , Issue 1 , March 2022 , Pages 11-22

Authors

Chovin Nawzad Ali 1 ; Dana Ahmed Sharif 2 ; Safa Ezadin Almukhtar 3

1 Nephrology Board Trainee, Ministry of Health, Kurdistan Region, Iraq.

2 College of Medicine, University of Sulaimani, University of Sulaimani, Kurdistan Region, Iraq.

3 College of Medicine, Hawler Medical University. Hawler, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10339

Keywords

Abstract

Background
Global increase in the incidence of end-stage renal disease has necessitated the performance of kidney
transplantation for many patients. To minimize the possibility of renal allograft failure and maintain graft
function. Kidney transplant recipients are typically given immunosuppressive drugs such as tacrolimus and
Cyclosporine in combination with other drugs.
Objectives
The present study was carried out to compare the effectiveness of tacrolimus versus Cyclosporine.
Patients and Methods
The present clinical non-randomized and non-controlled study was conducted on 201 kidney transplant patients
in Shar teaching Hospital in Sulaimani, Kurdistan region-Iraq, from April 2020 to April 2021. The patients
had received tacrolimus and Cyclosporine as immunosuppression drugs. Required data were collected from
the patients through their hospital records and direct interviews with them. The collected data were analyzed
through Statistical Package for Social Science (version 22.0).
Results
Most patients (60.7%) were aged 19-45 and males (70.6%). Most of them did not know the cause of chronic
kidney failure (41.3%), focal segmental glomerulosclerosis in 14.4%, and diabetes mellitus in 12.4%. Most
of the donors were non-related (90.5%). Induction treatment was anti-thymocyte globulin for most of them
(76.6%), and treatment after transplant, mycophenolate mofetil, Cyclosporine and prednisolone in 75% of
them. Acute cellular rejection was the most frequent complication after the transplant (23.4%). Tremor and
new onset of diabetes were the most frequent side effects of tacrolimus; however, hirsutism, hyperkalemia,
acne, hypertension, and hyperlipidemia are the most frequent side effects Cyclosporine. More patients on
Tacrolimus than Cyclosporine developed new onset of diabetes (7.5%). However, serum uric acid (p<0.001),
serum cholesterol (p<0.001), and serum triglyceride (p=0.01) levels elevate more with Cyclosporine group
patients. Moreover, drug change has a significant association with haemoglobin level (HGB) (p<0.001) and
serum triglyceride (p<0.001) in those group drug was changed to tacrolimus.
Conclusion
Similar rejection was obtained by using Tacrolimus and Cyclosporine within the first year after kidney
transplant in low immunological risk patients; however, acute cellular rejection was less with the TAC group.
It is less expensive than Cyclosporine in our region, but Cyclosporine is more available in the hospital.

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