Franke G H, Trampenau C, Reimer J
University of Applied Sciences Magdeburg-Stendal, Rehabilitation Psychology, Stendal, Germany.
Transplant Proc. 2006 Jun;38(5):1293-4. doi: 10.1016/j.transproceed.2006.02.081.
Advances in transplantation medicine are linked to improved efficacy of immunosuppressive agents. At the same time, these agents endanger medical success by side effects that may impair survival and quality of life (QOL). This study examined whether conversion to tacrolimus-based immunosuppression due to cyclosporine-related side effects improved. QOL in patients after kidney transplantation.
In total 64 patients (29 men) with an average age of 51 years (SD+/-12) who had received a kidney allograft an average of 5.6 years (SD+/-4) before conversion participated. The reasons for conversion were cardiovascular/metabolic (n=26) or periodontal/dermatological side effects (n=38) of cyclosporine therapy. QOL was assessed before conversion and in average 7 months thereafter by a global (SF-36) and a disease-specific instrument (ESRD-SCL).
Disease-specific QOL (ESRD-SCL, global index) improved significantly (P<.001, explanation of variance [EV]=16.6%) after conversion from cyclosporine to tacrolimus. In detail, cardiac and renal dysfunction (P<.01, EV=12.9%) as well as increased growth of gum and hair (P<.0001, EV=53.2%) were significantly reduced at end of the study. However, global QOL (SF-36) remained unchanged.
Regardless of the indication (cardiovascular or cosmetic), switching to tacrolimus due to cyclosporine-related side effects improved disease-specific QOL within the short term.
移植医学的进展与免疫抑制剂疗效的提高相关。与此同时，这些药物因可能损害生存率和生活质量（QOL）的副作用而危及医疗成功。本研究调查了因环孢素相关副作用而转换为以他克莫司为基础的免疫抑制治疗是否改善了肾移植患者的生活质量。
共有64例患者（29例男性）参与，平均年龄51岁（标准差±12），在转换治疗前平均已接受肾移植5.6年（标准差±4）。转换治疗的原因是环孢素治疗的心血管/代谢副作用（n = 26）或牙周/皮肤副作用（n = 38）。在转换治疗前及之后平均7个月，通过综合量表（SF - 36）和疾病特异性量表（ESRD - SCL）评估生活质量。
从环孢素转换为他克莫司治疗后，疾病特异性生活质量（ESRD - SCL，综合指数）显著改善（P <.001，方差解释率[EV] = 16.6%）。具体而言，在研究结束时，心脏和肾脏功能障碍（P <.01，EV = 12.9%）以及牙龈和毛发过度生长（P <.0001，EV = 53.2%）显著减轻。然而，综合生活质量（SF - 36）保持不变。
无论转换治疗的指征是心血管方面还是美容方面，因环孢素相关副作用而改用他克莫司在短期内改善了疾病特异性生活质量。
