Compared Cyclosporine A With Tacrolimus After Renal Transplantation: A Meta-analysis

Objective: To evaluate the effectiveness and safety of cyclosporine A (CsA)and tacrolimus (Tac) on acute rejection, function of transplanted kidney,survival rate of patients and grafts, hepatotoxicity, risk factors ofcardiovascular disease(high blood pressure, blood fat), hemoglobin andthe change of blood glucose.Methods: Searched postoperative treatment for patients with kidneytransplantation through the way of electronic retrieval and manualretrieval on electronic database: Medline(1994.1-2014.1),CNKI(1994.1-2014.1), CBM(1994.1-2014.1), CEBM/CCD, Cochrane Library andChin J Organ Transplant and other five Journals. Extracted randomizedcontrolled trials (RCTs) about comparing CsA with Tac after renaltransplantation. The dates were extracted and evaluated at least tworeviewers. The controversy about the studies was coped with discussion.The trials were assessed follow the quality of Jadad. The software ofRevMan5.2. was used for statistical analysis.Result: Firstly,499Chinese literature and343English literature werefound. Finally, effectiveness and safety of28RCTs (22English literature,6Chinese literature) about comparing CsA with Tac after renaltransplantation. The incidence of acute rejection of CsA was higher thanTac by follow up6and12months, statistical difference was found. Thesurvival rate of patients of CsA was higher than Tac by follow up6and12months, but P＞0.05, no statistical difference was found. The survivalrate of graft of CsA was lower than Tac by follow up6months, but P＞0.05, no statistical difference was found. The survival rate of graftof CsA was lower than Tac by follow up12months, statistical differencewas not found. The glomerular filtration rate of CsA was lower than Tac by follow up12months, statistical difference was found. The incidenceof hyperlipidemia of CsA was lower than Tac by follow up12months,statistical difference was found. The incidence of hyperglycemia of CsAwas lower than Tac by follow up12months, statistical difference was found.The incidence of high blood pressure of patients of CsA was higher thanTac by follow up12months, but P＞0.05, no statistical difference wasfound. The incidence of anemia of CsA was higher than Tac by follow up6months, but P＞0.05, no statistical difference was found. The incidenceof liver damage of CsA was higher than Tac by follow up12months,statistical difference was found.Conclusion: Compared with Tac, CsA mainly manifest higher incidence ofacute rejection，effects of renal function, hyperlipidemia and liverdamage. The incidence of hyperglycemia of CsA was lower than Tac. Nostatistical difference was found among the survival rate of patients, thesurvival rate of graft, the incidence of high blood pressure and theincidence of anemia.