Matthias Helmschrott 1 , Rasmus Rivinius 1 , Arjang Ruhparwar 2 , Bastian Schmack 2 , Christian Erbel 1 , Christian A Gleissner 1 , Mohammadreza Akhavanpoor 1 , Lutz Frankenstein 1 , Philipp Ehlermann 1 , Tom Bruckner 3 , Hugo A Katus 1 , Andreas O Doesch 1
24 February 2015
Nephrotoxicity is a serious adverse effect of calcineurin inhibitor therapy in patients after heart transplantation (HTX).
In this retrospective registry study, renal function within the first 2 years after HTX in patients receiving de novo calcineurin inhibitor treatment, that is, cyclosporine A (CSA) or tacrolimus (TAC), was analyzed. In a consecutive subgroup analysis, renal function in patients receiving conventional tacrolimus (CTAC) was compared with that of patients receiving extended-release tacrolimus (ETAC).
Data from 150 HTX patients at Heidelberg Heart Transplantation Center were retrospectively analyzed. All patients were continuously receiving the primarily applied calcineurin inhibitor during the first 2 years after HTX and received follow-up care according to center practice.
Within the first 2 years after HTX, serum creatinine increased significantly in patients receiving CSA ( P<0.0001), whereas in patients receiving TAC, change of serum creatinine was not statistically significant ( P=not statistically significant [ns]). McNemar’s test detected a significant accumulation of patients with deterioration of renal function in the first half year after HTX among patients receiving CSA ( P=0.0004). In patients receiving TAC, no significant accumulation of patients with deterioration of renal function during the first 2 years after HTX was detectable (all P=ns). Direct comparison of patients receiving CTAC versus those receiving ETAC detected no significant differences regarding renal function between patients primarily receiving CTAC or ETAC treatment during study period (all P=ns).