Safety Of Tacrolimus Versus Cyclosporin A In Renal Transplantation: A Meta-analysis

Objective:To evaluate the safety of Tacrolimus (Tac) versus cyclosporin A (CsA) after renal translantation.Methods: Searches were applied to the following electronic database:Medline; CNKI (1980.1-2007.1);Embase Database;Cochrane Liberary.Meanwhile,handsearch was applied in recent Chin J Organ Transplant and other five Journal. Randomized controlled trials (RCTs) comparing Tac with CsA for rejection after renal transplantation were included. Data were extracted independently by two reviewer. The methodological quality of trails was assessed by the Jadad-Score. Statistical analysis were performed with Ravman4.2.Result: At first, 11 Chinese papers and 157 foreign papers were found , Thirty-One RCTs comparing Tac with CsA for rejection after renal transplantation were identified, including 4 Chinese papers and 27 foreign papers.The post-transplant diabetes morbidity of Tac group was higher than that of CsA group with statistical difference during 1 year and 3 years;For post-transplant hypertension morbidity, no statistical difference was found between Tac and CsA group during 1 year and 3 years ;For post-transplant Hypercholesterolemia morbidity, no statistical difference was found between Tac and CsA group during 1 year , Hypercholesterolemia morbidity of Tac group was higher than CsA group with statistical difference group during 6 months;For post-transplant infection during 6 months and 1 years and the cytom egalovirus (CMV) infection during 6 months morbidity, no statistical difference was found between Tac and CsA group;The post-transplant neurological disorders morbidity of Tac group was higher than that of CsA group with statistical difference during 3 months and 6 months;The post-transplant digest system morbidity of Tac group was higher than that of CsA group with statistical difference during 1 years;The post-transplant hepatotoxicity morbidity of CsA group was higher than that of Tac group with statistical difference during 1 years;For post-transplant malignancies morbidity, no statistical difference was found between Tac and CsA group during 2 years ;The post-transplant gum hyperplasia morbidity of CsA group was higher than that of Tac group with statistical difference during 1 years;The post-transplant bone disease morbidity of CsA group was higher than that of Tac group with statistical difference during 2 years;The post-transplant Leukopenia morbidity of Tac group was higher than that of CsA group with statistical difference during 6 months.Conclusion: Compared with CsA, Tac represents higher diabetes incidence, higher morbidity of digest system and Leukopenia and lower hepatotoxicity incidence, lower morbidity of gum hyperplasia and bone disease.As the morbidity of hypertension,malignancies,infection and the cytom egalovirus (CMV) infection between Tac and CsA, statistical difference was not seen.