title: Tacrolimus in transplant rejection.
abstract: BACKGROUND
  Renal transplantation is the best therapy for patients with end-stage renal disease. To avoid graft rejection, adequate immunosuppressive therapy is crucial. Tacrolimus is approved for prophylaxis of transplant rejection in liver, kidney or heart allograft recipients and for the treatment of allograft rejection resistant to treatment with other immunosuppressive medicinal products.
  
  
  METHODS
  The objective of this review is to summarize the clinical efficacy of tacrolimus in renal transplantation with special emphasis on acute rejection, refractory rejection and nephrotoxicity and post-transplant diabetes mellitus as typical adverse effects of the drug.
  
  
  CONCLUSIONS
  Since its approval in 1994, tacrolimus has proven its efficacy as a cornerstone of modern immunosuppressive therapy not only in numerous randomized clinical trials but also in standard clinical care. Compared with cyclosporine, the use of tacrolimus in renal transplant recipients is associated with a reduced risk for acute rejection, a reduction in the occurrence of steroid-resistant rejection and a better graft function. The avoidance of nephrotoxicity and especially post-transplant diabetes mellitus are of major interest in long-term care of renal transplant recipients.
authors.affiliation: Department of Nephrology and Transplantation Medicine, Westpfalz-Klinikum, Hellmut-Hartert Straße 1, 67655 Kaiserslautern, Germany. trath@westpfalz-klinikum.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Rath
mesh_terms: D016572:Cyclosporine / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000209:etiology; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D016377:Organ Transplantation / Q000009:adverse effects; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus