Evolution to twice daily bolus intravenous tacrolimus: optimizing efficacy and safety of calcineurin inhibitor delivery early post lung transplant

Gregory I Snell, Steven Peter Ivulich, Lauren Anne Mitchell, Glen Philip Westall, Bronwyn Levvey

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12 Citations (Scopus)


Achieving therapeutic levels of cyclosporine (CSA) or Tacrolimus (TAC) early post lung transplantation (LTx) is challenging. Gut dysmotility, renal dysfunction and seizure risk are variably present and problematic. This study reports a single center evolution of CSA/TAC regimes used early post LTx, aiming to optimize efficacy and safety. Material/Methods: All adult LTx recipients from Aug 06-Aug 11 were divided into 4 cohorts: A) intravenous (IV) CSA twice daily (BD) 6 hr bolus then oral CSA, n=63; B) sub-lingual (SL) TAC BD then oral TAC, n=90; C) oral TAC BD, n=18; and D) IV TAC BD 4hr bolus then oral TAC, n=62. CSA/TAC trough levels were measured at days 1-7, 14 and 28 aiming for target trough levels >250 ng/ml and >8ng/ml respectively. Results: There were no differences in demographics, ICU and total length of stay between groups. Target trough levels were achieved in 13 * , 26 *, 17 and 37 of patients for Groups A-D respectively, (* p
Original languageEnglish
Pages (from-to)399 - 407
Number of pages9
JournalAnnals of Transplantation
Issue number1
Publication statusPublished - 2013

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