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Cyclosporin versus Tacrolimus as Primary Immunosuppressant after Liver Transplantation: A Meta-analysis
American Journal of Transplantation (2006)
  • Vivian C. McAlister, The University of Western Ontario
  • E. Haddad, The University of Western Ontario
  • E. Renouf, The University of Western Ontario
  • R. A. Malthaner, The University of Western Ontario
  • M. S. Kjaer
  • L. L. Gluud

A systematic review of randomized clinical trials (RCT) was undertaken to evaluate the beneficial and harmful effects of immunosuppression with cyclosporin versus tacrolimus for liver transplanted patients. MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were searched. Using fixed and random effects model, relative risk (RR), values <1 favoring>tacrolimus, with 95% confidence intervals (CI) were calculated. Of 717 potentially relevant references, 16 RCTs were eligible for inclusion. Mortality and graft loss at 1 year were significantly reduced in tacrolimus-treated recipients (Death: RR 0.85, 95% CI 0.73-0.99; graft loss: RR 0.73, 95% CI 0.61-0.86). Tacrolimus reduced the number of recipients with acute rejection (RR 0.81, 95% CI 0.75-0.88) and steroid-resistant rejection (RR 0.54, 95% CI 0.47-0.74) in the first year. Lymphoproliferative disorder or dialysis rates were not different but more de novo diabetes (RR 1.38, 95% CI 1.01-1.86) occurred with tacrolimus. More patients stopped cyclosporin than tacrolimus (RR 0.57, 95% CI 0.49-0.66). Treating 100 recipients with tacrolimus instead of cyclosporin would avoid rejection and steroid-resistant rejection in nine and seven patients respectively, graft loss and death in five and two patients respectively, but four additional patients would develop diabetes after liver transplantation.

  • Cyclosporine,
  • Graft Rejection,
  • Immunosuppressive Agents,
  • Liver Transplantation,
  • Risk Factors,
  • Tacrolimus
Publication Date
July, 2006
Citation Information
Vivian C. McAlister, E. Haddad, E. Renouf, R. A. Malthaner, et al.. "Cyclosporin versus Tacrolimus as Primary Immunosuppressant after Liver Transplantation: A Meta-analysis" American Journal of Transplantation Vol. 6 Iss. 7 (2006)
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