Still no final decision on best immunosuppressant after kidney transplantation

Since its introduction over a decade ago, cyclosporin has remained the most important immunosuppressant drug used in renal transplantation. Over the past few years, however, there has been a steady increase in the use of tacrolimus. Knoll et al (p 1104) conducted a systematic review of randomised controlled trials that compared tacrolimus with cyclosporin in renal transplantation. Patients who received tacrolimus had a significant reduction in the number of episodes of acute rejection compared with those treated with cyclosporin, but they also had a greater risk of developing new onset diabetes mellitus. There were no significant differences in patient or renal allograft survival 1 year after transplantation. Follow up studies are needed to determine whether tacrolimus improves long term renal graft survival.

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Relevant Article

Tacrolimus versus cyclosporin for immunosuppression in renal transplantation: meta-analysis of randomised trials

Greg A Knoll and Robert C Bell
BMJ 1999 318: 1104-1107. [Abstract] [Full Text] [PDF]