Renal complications and development of hypertension in the European study of FK 506 and cyclosporin in primary liver transplant recipients |
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Authors: | J Devlin R Williams P Neuhaus P McMaster R Calne R Pichlmayr G Otto H Bismuth C Groth |
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Institution: | Institute of Liver Studies, Kings College School of Medicine and Dentistry, Bessemer Road, London SE5 9RS, United Kingdom;Department of Surgery, Universitatsklinikum Rudolf Virchow, Berlin, Germany;Department of Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom;Department of Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom;Department of Abdominal and Transplantation Surgery, Medizinische Hochschule Hannover, Germany;Department of Surgery, University of Heidelberg, Germany;Service de Chirurgie, Hôpital Paul Browse, Villejuif, France;Department of Transplantation Surgery, Karolinska Institute, Huddinge Hospital, Sweden |
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Abstract: | Abstract We examined the occurrence of renal complications and hypertension in 540 primary liver recipients entered into the European liver trial comparing primary FK 506 to a cyclosporin A based immunosuppression regimen (CBIR). No difference in serious renal impairment or mean creatinine levels was observed with similar rates of "kidney failure" (FK 506 9.4% vs. CBIR 7.3%) and dialysis requirements (FK 506 12% vs. CBIR 11%). "Abnormal kidney function", a less serious parameter of renal impairment, was reported in 89 recipients (33 %) in the FK 506 group versus 58 (21%) in the CBIR group ( P <0.01). Development of this complication was associated with elevated intravenous FK 506 dosing schedules, with the mean cumulative dose 43% higher than treated patients with unaffected kidney function. In a later cohort of patients where intravenous dosing was lower, no significant difference in renal complications was detectable. The 6-month prevalence rate of systemic arterial hypertension was noted to be lower in the FK 506-treated patients compared to the CBIR group 33 (17.2%) vs. 47 (25.7%)]. |
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Keywords: | Immunosuppression Nephrotoxicity Transplantation |
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