A meta-analysis of therapeutic effect of cyclosporine microemulsion and tacrolimus for patients undergoing liver transplantation
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    Abstract:

    Objective:To evaluate the efficacy and safety of microemulsified cyclosporine (Neoral) and tacrolimus (FK506) for immunodepression after liver transplantation.Methods: According to the including criteria,fifteen randomized controlled trials were enrolled in this analysis.The data of trial design,characteristics of the subjects,and findings of the studies were reviewed and analyzed by RevMan 4.2.8 software.Results: The patient survival rate,graft survival rate,incidence of nephrotoxicity,and incidence of infection were not significantly different between Neoral and FK506 groups,with the relative risk and (95% CI,P) being 0.99(0.96-1.02,0.37),0.97(0.92-1.03,0.30),0.99(0.87-1.13,0.86) and 1.08(0.97-1.20,0.16),respectively.The incidences of hypertension (1.34\[1.15-1.55,0.000 1\]) and acute rejection (1.15\[1.06-1.25,0.001\])were significantly lower in the FK506 group,with no significant difference found in the degree of acute rejection (1.00\[0.92-1.22\],0.98).Interestingly,the incidence of diabetes was significantly higher in the FK506 group within 1 year after the operation,but was similar to that of the Neoral group thereafter,with relative risk(95%CI,P)being 0.72(0.62-0.83,<0.000 1) and 1.47(0.98-2.20,0.06),respectively.Conclusion: The 2 drugs have comparable patient/graft survival rates and incidences of nephrotoxicity and infection.FK506 can better reduce the incidence of acute rejection,but can not alleviate the degree of rejection.FK506 should be recommended for patients suffering from hypertension after liver transplantation and Neoral should be recommended for patients with diabetes.

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History
  • Received:October 13,2007
  • Revised:February 26,2008
  • Adopted:March 12,2008
  • Online: June 12,2008
  • Published:
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