Oral cyclosporine but not tacrolimus reduces renal transplant blood flow

Transplantation. 2004 May 15;77(9):1457-9. doi: 10.1097/01.tp.0000121196.71904.e0.


Background: Calcineurin inhibitors are important immunosuppressive agents, but cause nephrotoxicity.

Methods: Instantaneous intra-renal transplant hemodynamics were assessed in 22 patients using quantitative cineloop color Doppler imaging after dosing with microemulsion cyclosporine (CSA) or tacrolimus (TAC).

Results: CSA dosing resulted in renal hypoperfusion, with a mean relative reduction of 43%+/-20% (range 22-76%) in maximal fractional area (MFA) of color pixels to nadir, compared to baseline. The mean effect occurred 1.1+/-0.9 hr (median 1 hr) after CSA dosing and was abrogated by calcium channel blockers (P <0.05). The main renal artery velocities, resistive index and small vessel perfusion were unchanged, suggestive of medium-sized arteries mediated vasoconstriction. In contrast, TAC did not alter renal vascularity (2.3+/-4.0% absolute reduction of MFA color pixels vs. 10.7+/-6.5% with CSA, P <0.01).

Conclusion: CSA, but not TAC, induces phasic hypoperfusion of variable severity within small to medium sized intra-renal arteries soon after dosing, mitigated by calcium channel blockade.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Administration, Oral
  • Adult
  • Cyclosporine / administration & dosage*
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Renal Artery / drug effects
  • Renal Circulation / drug effects*
  • Tacrolimus / administration & dosage*


  • Immunosuppressive Agents
  • Cyclosporine
  • Tacrolimus