Adverse effects on the lipid profile of immunosuppressive regimens: tacrolimus versus cyclosporin measured using C2 levels.
Immunosuppression has improved graft and recipient survival in transplantation but is accompanied by several adverse effects like dyslipidemia and cardiovascular disease. Herein, we performed an observational, descriptive study to analyze the relationship of dyslipemia (hypercholesterolemia [hypercho] and hypertriglyceridemia [hypertg]) and cardiovascular disease with two different immunosuppressive regimens in liver transplantation: cyclosporine treatment based upon C2 levels (CsA2) and tacrolimus (Tac), both in combination with steroids. Seventy-four liver transplantation patients were included during a 2-year period: 35 with CsA2 and 39 with Tac. The mean follow-up was 40 months. There were no significant differences between the groups in terms of age, gender, Model for End-stage Liver Disease Score, Child stage, and indication for transplantation. The distribution of patients with HyperCho and HyperTg was independent of the immunosuppressive agent (P = NS), both in a global and in a stratified analysis at 6, 12, 24, and 60 months. The analysis of cardiovascular events revealed no differences between the groups (CsA2 14.3%; Tac 18.9%; P = NS). We suggest that CsA monitoring using C2 levels shows a safety profile similar to that of Tac with regard to the development of dyslipidemia and cardiovascular events.
Sánchez Pérez
B
B
Aranda Narváez
J M
JM
Suárez Muñoz
M A
MA
Fernández Aguilar
J L
JL
González Sánchez
A J
AJ
Pérez Daga
J A
JA
Santoyo Santoyo
J
J
D016572:Cyclosporine / Q000627:therapeutic use*; D050171:Dyslipidemias / Q000097:blood / Q000276:immunology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood; D015228:Hypertriglyceridemia / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D016031:Liver Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D016559:Tacrolimus / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D008055:Lipids; D016572:Cyclosporine; D016559:Tacrolimus