Tacrolimus (FK506) as primary immunosuppressant after lung transplantation.
Our positive experience with tacrolimus (FK 506) in heart transplantation has led to our assessing the use of this medication as a primary immunosuppressant in lung transplantation. 62 of our patients after lung transplantation were included in this study. The first 34 patients were treated with cyclosporine A (CyA), the remaining 28 with tacrolimus. No meaningful differences were found in baseline characteristics. The actuarial one-year survival rate was 70.6% for the CyA group and 92.3% for the tacrolimus group. The number of acute rejection episodes per patient was 1.50 for the CyA group versus 1.18 for the tacrolimus group (p < 0.05). The incidence of infection and their spectrum were comparable in both groups. The most frequently reported adverse events were diabetes mellitus 57% (tacrolimus) vs 23% (CyA), and renal insufficiency (27% vs 15%). Tacrolimus seems to be a more potent immunosuppressant after lung transplantation than CyA; on the other hand, diabetes and nephrotoxicity were diagnosed more frequently using tacrolimus. Although our results are very promising, further follow-up on the incidence of obliterative bronchiolitis is warranted.
Kur
F
F
Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig-Maximilian University, Munich, Germany.
Reichenspurner
H
H
Meiser
B M
BM
Welz
A
A
Fürst
H
H
Müller
C
C
Vogelmeier
C
C
Schwaiblmaier
M
M
Briegel
J
J
Reichart
B
B
D000206:Actuarial Analysis; D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016040:Lung Transplantation / Q000276:immunology*; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D015996:Survival Rate; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus; D008775:Methylprednisolone