title: Tacrolimus immunosuppression in high-risk corneal grafts.
abstract: BACKGROUND
  Unlike the immune privilege enjoyed by low-risk corneal grafts, high-risk corneal grafts experience rejection rates comparable to liver and kidney transplants. Systemic immunosuppression reduces the risk of rejection in high-risk corneal grafts.
  
  
  METHODS
  Systemic tacrolimus, a specific T cell inhibitor, was used at a mean daily dose of 2.5 mg to immunosuppress 43 patients undergoing high-risk corneal transplantation. Immunosuppression was continued for a period of 18-24 months after the high-risk corneal graft.
  
  
  RESULTS
  During a mean follow-up period of 33.7 months, clarity of the graft was maintained in 65% of patients. Eight patients experienced rejection episodes while on tacrolimus, and this led to graft failure in five patients.
  
  
  CONCLUSIONS
  Tacrolimus is relatively safe and effective in reducing rejection and prolonging graft survival in patients with high-risk keratoplasty compared with other series where similar immunosuppression was not used.
authors.affiliation: Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Joseph
authors.forename: D
authors.initials: D
authors.lastname: Raj
authors.forename: V
authors.initials: V
authors.lastname: Shanmuganathan
authors.forename: R J
authors.initials: RJ
authors.lastname: Powell
authors.forename: H S
authors.initials: HS
authors.lastname: Dua
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016039:Corneal Transplantation; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016559:Tacrolimus / Q000008:administration & dosage* / Q000009:adverse effects / Q000276:immunology
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus