Comparison of patient and graft survival in tacrolimus versus cyclosporine-based immunosuppressive regimes in renal transplant recipients – Single-center experience from South India

Studies have shown better graft function and reduced acute rejection rates among renal transplant recipients who were on Tacrolimus (Tac)-based immunosuppression regimens as compared to cyclosporine (CsA)-based regimens in the first year. However, the long-term follow-up data did not reveal better outcomes in the Tac-based regimens. In view of the short term benefits, the trend has been to change to Tac-based regimens off late. Data from the Indian subcontinent are, however, sparse. We, therefore, looked at our data to ascertain if Tac-based regimen does have better outcomes in our population. We studied a total of 108 individuals who underwent renal transplantation between January 2007 and June 2013, with a mean follow-up of 38.22 months (comparable to both groups). In our group, males constituted 77.8%,; and among the 108 individuals, 16.7% were diabetics. New-onset diabetes after renal transplantation was more common in the Tac group (21 vs. 12 and was statistically significant [P = 0.03]). At the last follow-up, serum creatinine was higher in the CsA group (1.77 mg/dl vs. 1.35 mg/dl) and was statistically significant (P = 0.03). Individuals requiring hemodialysis were also significantly higher in the CsA group (9 vs. 2; P = 0.05). The patient survival was similar in both groups (1-year and 5-year follow-up); however, graft survival was better in Tac group as compared to CsA group (0.94 vs. 0.88 at 1 year and 0.85 vs. 0.72 at 5 years).