In a retrospective analysis we compared the outcome of a group of 63 kidney
or kidney/pancreas transplant recipients who were transplanted between Jun
e 1994 and February 1997 and received either tacrolimus (FK, n = 22) or Neo
ral (NEO, n = 41) as part of a triple immunosuppressive protocol. Ten patie
nts in the NEO group had recurrent rejection episodes between 1 and 8 month
s post-transplant and were converted to FK. CellCept was the secondary immu
nosuppressive agent in about half the FK, three-quarters of the NEO, and in
all but one in the conversion (CON) groups. Patients in all groups were on
prednisone in equal amounts. Mean duration of follow-up for FK, NEO and CO
N groups was 32, 19 and 13 months, respectively. One-yr patient and graft s
urvival was 100% in all groups. At 2 yr, graft survival was 95, 96 and 100%
in FK, NEO and CON groups, respectively. Acute rejection at 1 yr was twice
as high in the NEO group as the FK group. There were no rejection episodes
among the FK patients who also received CellCept. The mean current serum c
reatinines (mg%) were: FK = 1.6, NEO = 1.8, CON = 1.9. Recurrent infection
was more common with FK (8/22) than NEO (1/31) (p = 0.023). Our experience
suggests there is less rejection but more infection in recipients treated w
ith FK compared to NEO. In patients with recurrent rejection, conversion fr
om NEO to FK stabilizes renal function and minimizes subsequent rejection e
pisodes.