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KMID : 0869620080250010046
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Journal of Korean Society of Hospital Pharmacists
2008 Volume.25 No. 1 p.46 ~ p.53
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Jeon Su-Jin
Lee Ju-Yeun
Han Hyun-Joo
Son In-Ja
Oh Jung-Mi
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Abstract
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Cyclosporine and tacrolimus are essential immunosuppressants for liver transplant patients in the prophylaxis of transplant rejection. However, they have various side effects, which can greatly affect the quality of life, morbidity and mortality of the patients. Although they both have an efficacy of preventing rejection as calcineurin inhibitors, it has been reported that their adverse effects profile is different from each other. The objectives of this study were to compare and to evaluate the adverse effect profile of two immunosuppressants in the liver transplant recipients under the routine clinical settings. The patients received liver transplantation from January of 2001 to March of 2005 in Seoul National University Hospital and followed up for more than 6 months. Possible adverse effects such as renal dysfunction, hypertension, diabetes, dyslipidemia were monitored based on medical records and prescription records. Fifty one patients received the cyclosporine and one hundred eleven patients received tacrolimus. Average terms of follow up were 26.4 months and 27.2 months, respectfully. All the patients took steroid as initial immunosuppressant. More than half of the patients took mycophenolate in conjunction. Renal dysfunction occurred in 66 patients(40.5 %) of total patients. The incidence of renal dysfunction was similar between cyclosporine group and tacrolimus group(41.2% vs. 40.5%, p = 0.94). Hypertension was significantly more common in cyclosporine group than in tacrolimus group(42.2 % vs. 17.4, p <0.05). Dyslipidemia also occurred more frequently in cyclosporine group than in tacrolimus group(21.6% vs. 7.21%, P < 0.01). However, the incidence of post-transplant diabetes mellitus was higher in tacrolimus group than in cyclosporine group, although it was not statistically significant(39.0% vs. 29.7%, p = 0.069). The neuropsychiatric adverse effects were similar between the two groups. However, seizure occurred in two patients, all of them received tacrolimus.
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KEYWORD
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liver transplantation, cyclosporine, tacrolimus, adverse effects
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