A Comparison Between Tacrolimus and Cyclosporine As Immunosuppression after Renal Transplantation in Children, A Meta-Analysis and Systematic Review

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RAVANSHAD YALDA; AZARFAR ANOUSH; RAVANSHAD SAHAR; Naderi Nasab Malihe; GHASEMI ALI; Golsorkhi Mohaddeseh; MOSTAFAVIAN ZAHRA; ESMAEELI MOHAMMAD; Mehrad Majd Hassan

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Journal: Iranian Journal of Kidney Diseases Year:2020 | Volume:14 | Issue:2 Page(s): 139-144

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Title

A Comparison Between Tacrolimus and Cyclosporine As Immunosuppression after Renal Transplantation in Children, A Meta-Analysis and Systematic Review

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Keywords

transplantation

cyclosporine

tacrolimus

calcineurin inhibitors

meta-analysis

children

Abstract

Introduction. There are some randomized trials which have already evaluated different calcineurin inhibitors (CNIs), especially comparing tacrolimus and cyclosporine, as immunosuppressant agents in children. However, their findings have been occasionally conflicting and thus debatable. Therefore, the evidence on safety and efficacy of immunosuppressive therapy after kidney transplantation in children has been inconclusive and argued to date. This study was aimed to compare the benefits and disadvantages of tacrolimus versus cyclosporine as the primary immunosuppression after renal transplantation in children. Methods. A systematic review and meta-analysis was done. An electronic literature review was conducted to identify appropriate studies. The outcomes were presented as relative risk, with 95% confidence intervals. Results. Five qualified randomized controlled trials were included in this systematic review. tacrolimus was insignificantly superior to cyclosporine considering the total effect size of graft loss (RR = 0. 67, 95% CI: 0. 40-1. 11; P >. 05) and acute rejection (RR = 0. 79, 95% CI: 0. 59 – 1. 05; P >. 05). On the contrary, cyclosporine seemed to be insignificantly superior to tacrolimus regarding mortality rate (RR = 1. 06, 95% CI: 0. 59-1. 90; P >. 05). Conclusion. Admitting the study limitations mainly because of the nature and case study size of the included trials, it can be concluded from our systematic review results that tacrolimus seems insignificantly superior to cyclosporine respecting graft loss and acute rejection. However, cyclosporine was shown to be insignificantly superior regarding mortality rate. However additional studies with a larger sample size are highly recommended.

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APA: Copy

RAVANSHAD, YALDA, AZARFAR, ANOUSH, RAVANSHAD, SAHAR, Naderi Nasab, Malihe, GHASEMI, ALI, Golsorkhi, Mohaddeseh, MOSTAFAVIAN, ZAHRA, ESMAEELI, MOHAMMAD, & Mehrad Majd, Hassan. (2020). A Comparison Between Tacrolimus and Cyclosporine As Immunosuppression after Renal Transplantation in Children, A Meta-Analysis and Systematic Review. IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD), 14(2), 139-144. SID. https://sid.ir/paper/750075/en

Vancouver: Copy

RAVANSHAD YALDA, AZARFAR ANOUSH, RAVANSHAD SAHAR, Naderi Nasab Malihe, GHASEMI ALI, Golsorkhi Mohaddeseh, MOSTAFAVIAN ZAHRA, ESMAEELI MOHAMMAD, Mehrad Majd Hassan. A Comparison Between Tacrolimus and Cyclosporine As Immunosuppression after Renal Transplantation in Children, A Meta-Analysis and Systematic Review. IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD)[Internet]. 2020;14(2):139-144. Available from: https://sid.ir/paper/750075/en

IEEE: Copy

YALDA RAVANSHAD, ANOUSH AZARFAR, SAHAR RAVANSHAD, Malihe Naderi Nasab, ALI GHASEMI, Mohaddeseh Golsorkhi, ZAHRA MOSTAFAVIAN, MOHAMMAD ESMAEELI, and Hassan Mehrad Majd, “A Comparison Between Tacrolimus and Cyclosporine As Immunosuppression after Renal Transplantation in Children, A Meta-Analysis and Systematic Review,” IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD), vol. 14, no. 2, pp. 139–144, 2020, [Online]. Available: https://sid.ir/paper/750075/en

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