The effect of conversion from cyclosporine to tacrolimus on gingival hyperplasia, hirsutism and cholesterol

The use of cyclosporine for immunosuppression in renal transplantation allo graft recipients is associated with hypertrichosis, gingival hyperplasia, a nd hypercholesterolemia. Conversion of patients to tacrolimus may lead to a n improvement in these effects with minimal risk of rejection or allograft dysfunction. Methods. Sixteen renal transplant recipients were prospectively converted f rom CsA to tacrolimus and followed for 1 year. Gingival hyperplasia index, total cholesterol, and blood pressure were recorded at the outset, 4-, 8-, and 12-month intervals. Glomerular filtration rate was checked before conve rsion and 1 year later. Photographs documenting hypertrichosis were taken b efore conversion and 1 year later. Adverse effects from tacrolimus were rec orded at 4, 8, and 12 months. Results. Twelve patients with hypertrichosis noted rapid improvement. Mean gingival hyperplasia index decreased from 24 to 6; mean total cholesterol d ecreased from 237 to 195, Glomerular filtration rate was essentially unchan ged (56 to 54), One episode of rejection occurred, three patients developed diarrhea, three noted headaches, and one had a tremor. Conclusion. If carefully monitored, patients suffering adverse effects seco ndary to cyclosporine may be converted to tacrolimus with minimal risk of a llograft dysfunction or rejection.