The effect of conversion from cyclosporine to tacrolimus on gingival hyperplasia, hirsutism and cholesterol.
The use of cyclosporine for immunosuppression in renal transplantation allograft recipients is associated with hypertrichosis, gingival hyperplasia, and hypercholesterolemia. Conversion of patients to tacrolimus may lead to an improvement in these effects with minimal risk of rejection or allograft dysfunction.


METHODS
Sixteen renal transplant recipients were prospectively converted from CsA to tacrolimus and followed for 1 year. Gingival hyperplasia index, total cholesterol, and blood pressure were recorded at the outset, 4-, 8-, and 12-month intervals. Glomerular filtration rate was checked before conversion and 1 year later. Photographs documenting hypertrichosis were taken before conversion and 1 year later. Adverse effects from tacrolimus were recorded at 4, 8, and 12 months.


RESULTS
Twelve patients with hypertrichosis noted rapid improvement. Mean gingival hyperplasia index decreased from 24 to 6; mean total cholesterol decreased from 237 to 195. Glomerular filtration rate was essentially unchanged (56 to 54). One episode of rejection occurred, three patients developed diarrhea, three noted headaches, and one had a tremor.


CONCLUSIONS
If carefully monitored, patients suffering adverse effects secondary to cyclosporine may be converted to tacrolimus with minimal risk of allograft dysfunction or rejection.
Thorp
M
M
Oregon Health Sciences University, Division of Nephrology, Hypertension and Clinical Pharmacology, Portland 97201-3098, USA.
DeMattos
A
A
Bennett
W
W
Barry
J
J
Norman
D
D
D000293:Adolescent; D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use*; D003967:Diarrhea / Q000139:chemically induced; D005260:Female; D005885:Gingival Hyperplasia / Q000188:drug therapy*; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D006983:Hypertrichosis / Q000188:drug therapy*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus