title: Tacrolimus may be associated with lower osteonecrosis rates after renal transplantation.
abstract: To compare the effect of two immunosuppressive agents, cyclosporin A and tacrolimus, in terms of the development of osteonecrosis after renal transplantation, a cohort study was done. The cyclosporin A group and the tacrolimus group consisted of 32 patients each, and were matched for age, gender, and renal allograft (cadaveric or living). Four patients with osteonecrosis of the femoral head and one patient with osteonecrosis of the knee were observed in the cyclosporin A group, whereas none of the patients in the tacrolimus group had osteonecrosis. All five patients with osteonecrosis were diagnosed on magnetic resonance imaging within 2 years after renal transplantation, and were followed up for more than 3 years after diagnosis. Significant differences were observed in the number of patients with acute rejection (cyclosporin A, 16 patients versus tacrolimus, seven patients). Significant differences also were found in the dose of pulse corticosteroids at 2 weeks (cyclosporin A, 1161.1 +/- 939.6 mg versus tacrolimus, 674.3 +/- 587.5 mg) and 4 weeks after transplantation (1727.5 +/- 1399.9 mg versus 965.0 +/- 861.9 mg). The risk of osteonecrosis after renal transplantation was reduced in the patients who used tacrolimus for immunosuppression, which reduced the number of acute rejection episodes and the dose of pulse corticosteroid administration.
authors: Department of Orthopaedic Surgery, Osaka National Hospital, Osaka University Medical School, Osaka, Japan. tsakai-osk@umin.ac.jp
authors: Takashi
authors: T
authors: Sakai
authors: Nobuhiko
authors: N
authors: Sugano
authors: Yukito
authors: Y
authors: Kokado
authors: Shirou
authors: S
authors: Takahara
authors: Kenji
authors: K
authors: Ohzono
authors: Hideki
authors: H
authors: Yoshikawa
mesh_terms: D000208:Acute Disease; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D016572:Cyclosporine / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005271:Femur Head Necrosis / Q000139:chemically induced* / Q000175:diagnosis; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000276:immunology; D007717:Knee; D008279:Magnetic Resonance Imaging; D008297:Male; D010020:Osteonecrosis / Q000139:chemically induced* / Q000175:diagnosis; D011239:Prednisolone / Q000008:administration & dosage; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D016559:Tacrolimus