TY - JOUR
T1 - Evolution to twice daily bolus intravenous tacrolimus: optimizing efficacy and safety of calcineurin inhibitor delivery early post lung transplant
AU - Snell, Gregory I
AU - Ivulich, Steven Peter
AU - Mitchell, Lauren Anne
AU - Westall, Glen Philip
AU - Levvey, Bronwyn
PY - 2013
Y1 - 2013
N2 - 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
AB - 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
UR - http://www.ncbi.nlm.nih.gov/pubmed/23921892
U2 - 10.12659/AOT.883993
DO - 10.12659/AOT.883993
M3 - Article
SN - 1425-9524
VL - 18
SP - 399
EP - 407
JO - Annals of Transplantation
JF - Annals of Transplantation
IS - 1
ER -