A randomized trial of tacrolimus (FK506) versus total lymphoid irradiation for the control of repetitive rejection after cardiac transplantation.
Recurrent cardiac rejection is a major cause of morbidity during the initial 6 months following transplantation. We compared treatment with tacrolimus versus total lymphoid irradiation in 13 heart transplant recipients on a cyclosporine, azathioprine, and prednisolone regimen, who experienced repetitive rejection. The mean number of episodes of rejection significantly decreased in both groups, with no deaths and no increase in the incidence of infection, hypertension, diabetes, or renal impairment following either treatment at 12-month follow-up. Conversion to tacrolimus or a course of lymphoid irradiation are equipotent strategies, of comparable cost, for the prevention of further rejection in patients with recurrent rejection.
Keogh
A M
AM
Heart and Lung Transplant Unit, St. Vincent's Hospital, Sydney, New South Wales, Australia. akeogh@stvincents.com.au
Arnold
R H
RH
Macdonald
P S
PS
Hawkins
R C
RC
Morgan
G W
GW
Spratt
P M
PM
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology / Q000628:therapy*; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D015182:Lymphatic Irradiation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D016559:Tacrolimus