early conversion to tacrolimus vs cyclosporine continuation in normally functioning kidney allograft: a single-center study

This study evaluated the effectiveness of early pre-emptive conversion from cyclosporine to tacrolimus in kidney transplant patients with normal graft function and in the absence of adverse effects of the initial cyclosporine. a historical cohort study of 166 patients who received deceased-donor kidney transplant between 2011 to 2017 was conducted. all the patients had been treated with cyclosporine (sandimmune®) during their immediate post-transplantation period. at the time of hospital discharge, the patients were divided into 2 groups: patients with continued cyclosporine (sandimmune®) treatment (n = 125) and the patients whose treatments converted from cyclosporine to tacrolimus (prograf®) at discharge (n = 41). the 1-year graft function (p = 0.074), acute rejection (p = 0.566), and graft loss (p = 0.566) were not significantly different between two groups. the patients on tacrolimus had lower levels of cholesterol (p = 0.002) and diastolic blood pressure (p = 0.015). the long-term follow-up showed no significant difference in graft loss (p = 0.566). the patients received tacrolimus had higher all-cause mortality within the first year posttransplantation (p = 0.002) as well as long-term follow-up (p = 0.001). the continuation of initial cyclosporine might be a good option when the graft function is acceptable and the adverse effects are absent.