Abstract

Background: There are few studies suggesting prevalence of tacrolimus in preventing acute rejection of the graft in comparison to cyclosporine-A in patients after OHT. Aim. The aim of the study was to assess early results of OHT after introduction of tacrolimus as part of the primary immunosuppressive protocol.
Material/Methods: We analyzed the results of 328 consecutive OHT procedures performed in the Silesian Centre for Heart Disease between 18.06.2000 and 30.06.2008. In the primary immunosuppression tacrolimus was used in 72 pts (group A; 59M/13F, 48±10 y.o.), cyclosporine-A in 214 pts. (group B; 188M/26F, 45±16 y.o.). 1.year survival, acute rejection (AR), glomerular filtration rate (GFR) and infection episodes were assessed.
Results: 1-year survival was 77% and was the same in both groups. Primary
graft failure was the cause of all 42 deaths. AR episodes occurred in 64
vs.78% of pts. in group A compared to group B (p=0.02). Average number of AR>3A was 1.1±1.0 vs. 2.0±1.8 (p=0.01) in the group A vs.B respectively. GFR in the first month after OHT was 89.1±46.0 vs.78.4±32.4 in group A compared to group B (p=0.02). The rate of bacterial and viral infection was similar in both groups (31%).
Conclusions: Tacrolimus used in primary immunosuppressive protocol is related to the same survival and infectious complications, but to lesser degree of acute rejection and renal impairment in comparison to cyclosporine-A.

Keywords: Heart Transplantation, Immunosuppression