TY - JOUR
T1 - International experience with conversion from cyclosporine to tacrolimus for acute and chronic lung allograft rejection
AU - Sarahrudi, Kambiz
AU - Estenne, Marc
AU - Corris, Paul
AU - Niedermayer, Jost
AU - Knoop, Christiane
AU - Glanville, Allan
AU - Chaparro, Cecilia
AU - Verleden, Geert
AU - Gerbase, Margaret W.
AU - Venuta, Federico
AU - Böttcher, Heidi
AU - Aubert, John D.
AU - Levvey, Bronwyn
AU - Reichenspurner, Hermann
AU - Auterith, Alexandra
AU - Klepetko, Walter
PY - 2004/4
Y1 - 2004/4
N2 - Objective: A retrospective study involving 13 institutions was performed to assess the efficacy of conversion from cyclosporine (INN: ciclosporin) to tacrolimus. Methods: Data from 244 patients were analyzed. Indications for conversion were recurrent-ongoing rejection (n = 110) and stage 1 to 3 bronchiolitis obliterans syndrome (n = 134). Results: The incidence of acute rejection decreased significantly within 3 months after versus before the switch from cyclosporine to tacrolimus (P < .01). For patients with recurrent-ongoing rejection, the forced expiratory volume in 1 second decreased by 1.96% of predicted value per month (P = .08 vs zero slope) before and increased by 0.34% of predicted value per month (P = .32 vs zero slope) after conversion (P < .06). For patients with stage 1 to 3 bronchiolitis obliterans syndrome, a significant reduction of rejection episodes was observed (P < .01). In single transplant recipients a decrease of the forced expiratory volume in 1 second averaged 2.25% of predicted value per month (P < .01 vs zero slope) before and 0.29% of predicted value per month after conversion. Corresponding values for bilateral transplant recipients were 3.7% of predicted value per month (P < .01 vs zero slope) and 0.9% of predicted value per month (P = 0.04 vs zero slope), respectively. No significant difference in the incidence of infections within 3 months before and after conversion was observed. Conclusions: Conversion from cyclosporine to tacrolimus after lung transplantation is associated with reversal of recurrent-ongoing rejection. Conversion for bronchiolitis obliterans syndrome allows short-term stabilization of lung function in most patients.
AB - Objective: A retrospective study involving 13 institutions was performed to assess the efficacy of conversion from cyclosporine (INN: ciclosporin) to tacrolimus. Methods: Data from 244 patients were analyzed. Indications for conversion were recurrent-ongoing rejection (n = 110) and stage 1 to 3 bronchiolitis obliterans syndrome (n = 134). Results: The incidence of acute rejection decreased significantly within 3 months after versus before the switch from cyclosporine to tacrolimus (P < .01). For patients with recurrent-ongoing rejection, the forced expiratory volume in 1 second decreased by 1.96% of predicted value per month (P = .08 vs zero slope) before and increased by 0.34% of predicted value per month (P = .32 vs zero slope) after conversion (P < .06). For patients with stage 1 to 3 bronchiolitis obliterans syndrome, a significant reduction of rejection episodes was observed (P < .01). In single transplant recipients a decrease of the forced expiratory volume in 1 second averaged 2.25% of predicted value per month (P < .01 vs zero slope) before and 0.29% of predicted value per month after conversion. Corresponding values for bilateral transplant recipients were 3.7% of predicted value per month (P < .01 vs zero slope) and 0.9% of predicted value per month (P = 0.04 vs zero slope), respectively. No significant difference in the incidence of infections within 3 months before and after conversion was observed. Conclusions: Conversion from cyclosporine to tacrolimus after lung transplantation is associated with reversal of recurrent-ongoing rejection. Conversion for bronchiolitis obliterans syndrome allows short-term stabilization of lung function in most patients.
UR - http://www.scopus.com/inward/record.url?scp=11144354110&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2003.11.009
DO - 10.1016/j.jtcvs.2003.11.009
M3 - Article
AN - SCOPUS:11144354110
SN - 0022-5223
VL - 127
SP - 1126
EP - 1132
JO - The Journal of Thoracic and Cardiovascular Surgery
JF - The Journal of Thoracic and Cardiovascular Surgery
IS - 4
ER -