Dr McAlistera and colleagues from Denmark evaluated the beneficial and harmful effects of immunosuppression with cyclosporin vs tacrolimus for liver transplanted patients.
The research team undertook a systematic review of randomized clinical trials.
MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were searched.
The team used fixed and random effects models, relative risk, and values less than 1 favoring tacrolimus with 95% confidence intervals were calculated.
Of 717 potentially relevant references, 16 randomized clinical trials were eligible for inclusion.
|Mortality and graft loss at 1 year were reduced with tacrolimus|
|American Journal of Transplantation|
Mortality and graft loss at 1 year were significantly reduced in tacrolimus-treated recipients.
The researcher observed that tacrolimus reduced the number of recipients with acute rejection and steroid-resistant rejection in the first year.
Lymphoproliferative disorder or dialysis rates were not different but more de novo diabetes occurred with tacrolimus.
The team noted that more patients stopped cyclosporin than tacrolimus.
Dr McAlistera's team concluded, “Treating 100 recipients with tacrolimus instead of cyclosporin would avoid rejection and steroid-resistant rejection in 9 and 7 patients respectively.”
“Graft loss and death would be reduced in 5 and 2 patients respectively, but 4 additional patients would develop diabetes after liver transplantation.”