Akademik Veri Yönetim Sistemi
EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, sa. 27, ss.5128-5135, 2023 (SCI-Expanded)
Abstract. – OBJECTIVE: The aim of this
study is to compare the effects of cyclosporine
(CsA) and tacrolimus (TAC) on preventing acute
rejection and analyze the side-effect profiles of
both agents, particularly on kidney functions.
PATIENTS AND METHODS: In our study,
71 patients who underwent heart transplantation were included. For maintenance immunosuppression, 28 of these patients were treated with mycophenolate mofetil (MMF), steroid, and steroid CsA, and 43 of them were
treated with MMF steroid and TAC. Endomyocardial biopsy results of the patients in the
first month and the first year were compared.
In the follow-ups, creatinine values and other
parameters were recorded.
RESULTS: Endomyocardial biopsy (EMB) performed at 1 month showed no rejection in 12 patients (42.9%) in the CsA group, grade 1R rejection in 15 patients (53.6%), and grade 2R rejection in one patient (3.6%). In the TAC group, rejection was not detected in 25 patients (58.1%),
while grade 1R rejection was diagnosed in 17 patients (39.5%) and grade 2R rejection in 1 patient
(2.3%) (p=0.4). In EMBs performed in the first
year, 14 patients (51.9%) in the CsA group did
not have rejection, 12 patients (44.4%) had grade
1R rejection, and one patient (3.7%) had grade
2R rejection. In the TAC group, grade 0R rejection was diagnosed in 23 patients (60.5%), grade
1R rejection in 15 patients (39.5%), and grade 2R
rejection was not detected. Postoperative firstweek creatinine values, which were found to be
higher in the CsA group, were significant compared to the TAC group (p=0.028).
CONCLUSIONS: TAC and CsA are drugs that
help prevent acute rejection after heart transplantation and can be used safely in heart transplant
recipients. Neither drug is superior to the other in preventing rejection. TAC may be preferred
to CsA as it has fewer negative effects on kidney
functions in the early postoperative period.