Effect of onversion from ciclosporin to tacrolimus on endothelial progenitor cells in stable long-term kidney transplant recipients.
Riegersperger M, Plischke M, et al.Transplantation 2013;95(11):1338-45.
Aims
To examine whether conversion from ciclosporin (CSA) to Tacrolimus (TAC)-based immunosuppression increases endothelial progenitor cell (EPC) counts in stable long term kidney transplant recipients.
Interventions
The experimental group converted from CSA to TAC at target trough levels of 5-8ng/mL in combination with/without mycophenolate mofetil and with/without steroids. The control group was maintained on CSA in combination with/without MMF and with/without steroids without change in the target trough levels of 70-150ng/mL.
Participants
148 stable long-term kidney transplant recipients.
Outcomes
The primary endpoint was the effect of conversion from CSA to TAC based immunosuppressive therapy on EPC count on month 24. The secondary endpoints included renal function as assessed by cystatin c measurement, serum creatinine, and serum creatinine-based equations to estimate GFR and pharmacogenetic evaluations.
Follow-up
24 months.
CET Conclusions
Conversion from ciclosporin to tacrolimus in stable kidney transplant recipients has no effect on endothelial progenitor cells at 24 months. Counts of endothelial progenitor cells declined slightly in both groups. No difference was seen in acute rejection rates, or graft function at 24 months. There was no difference in blood pressure, serum lipid profile or HbA1c at 24 months.
Data analysis
Modified intention-to-treat analysis
Trial registration
ClinicalTrials.gov - NCT00182559 and EudraCT 2004-004209-98