HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Si M. Pham Robert L. Kormos Brack G. Hattler Robert L. Hardesty Bartley P. Griffith Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pham, S. M. Articles by Griffith, B. P. Search for Related Content PubMed PubMed Citation Articles by Pham, S. M. Articles by Griffith, B. P.

J Thorac Cardiovasc Surg 1996;111:764-772
© 1996 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

A PROSPECTIVE TRIAL OF TACROLIMUS (FK 506) IN CLINICAL HEART TRANSPLANTATION: INTERMEDIATE-TERM RESULTS

Received for publication April 27, 1995 Revisions requested May 31, 1995; revisions received Oct. 20, 1995 Accepted for publication Oct. 27, 1995. Address for reprints: Si M. Pham, MD, Department of Surgery, Division of Cardiothoracic Surgery, Suite C-700 PUH< 200 Lothrop St., Pittsburgh, PA 15213.

Abstract

Between January 1, 1989, and December 31, 1994, we have treated 122 primary heart recipients with FK 506 (group I) and 121 with cyclosporine (group II). Fifty patients in the cyclosporine (CyA) group received no lympholytic induction (CyA alone) and 71 others received lympholytic induction with either rabbit antithymocyte globulin or OKT3 (CyA+LI). The mean follow-up was longer in the FK 506 group than in the CyA groups (3.2 ± 1.3 vs 2.3 ± 1.8 years; p< 0.01). Patient survival did not differ on the basis of the type of immunosuppression used. At 3 months after transplantation, the freedom from rejection in the FK 506 group was higher than that of the CyA-alone group (47% vs 22%, p< 0.01) but similar to that of the CyA+LI group (47% vs 53%). The linearized rejection rate (episodes/100 patient-days) of the FK 506 group (0.09 episodes) was lower (p< 0.05) than that of the CyA-alone group (0.26) and the CyA+LI group (0.13). The requirement for pulsed steroids to treat rejection was less in common in the FK 506 group than in either CyA group. Eighteen patients in the CyA group had refractory rejections; all resolved with FK 506 rescue. Two patients in the FK 506 group had refractory rejection that resolved with total lymphoid irradiation (n= 1) and methotrexate therapy (n= 1). Patients receiving FK 506 had a lower risk of hypertension and required a lower dose of steroids. Although the mean serum creatinine concentration at 1 year was higher in the FK 506 group, this difference disappeared after 2 years. No patients required discontinuation of FK 506 because of its side effects. Our intermediate-term results indicate that FK 506 compares favorably with CyA as a primary immunosuppressant in heart transplantation. (J THORACCARDIOVASCSURG1996;111:764-72)

This article has been cited by other articles:

				M. Isobe, H. Kosuge, and J.-i. Suzuki T Cell Costimulation in the Development of Cardiac Allograft Vasculopathy: Potential Targets for Therapeutic Interventions Arterioscler. Thromb. Vasc. Biol., July 1, 2006; 26(7): 1447 - 1456. [Abstract] [Full Text] [PDF]

				P. Petrakopoulou, L. Anthopoulou, M. Muscholl, V. Klauss, W. von Scheidt, P. Uberfuhr, B. M. Meiser, B. Reichart, and M. Weis Coronary Endothelial Vasomotor Function and Vascular Remodeling in Heart Transplant Recipients Randomized for Tacrolimus or Cyclosporine Immunosuppression J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1622 - 1629. [Abstract] [Full Text] [PDF]

				X. M. Mueller Drug immunosuppression therapy for adult heart transplantation. Part 2: clinical applications and results Ann. Thorac. Surg., January 1, 2004; 77(1): 363 - 371. [Abstract] [Full Text] [PDF]

				D. O. Taylor Cardiac transplantation: drug regimens for the 21st century Ann. Thorac. Surg., June 1, 2003; 75(90060): S72 - 78. [Abstract] [Full Text] [PDF]

				V. M. Montori, A. Basu, P. J. Erwin, J. A. Velosa, S. E. Gabriel, and Y. C. Kudva Posttransplantation Diabetes: A systematic review of the literature Diabetes Care, March 1, 2002; 25(3): 583 - 592. [Abstract] [Full Text] [PDF]

				J. F. GUMMERT, T. IKONEN, and R. E. MORRIS Newer Immunosuppressive Drugs: A Review J. Am. Soc. Nephrol., June 1, 1999; 10(6): 1366 - 1380. [Abstract] [Full Text]

				V. Ratanatharathorn, R. A. Nash, D. Przepiorka, S. M. Devine, J. L. Klein, D. Weisdorf, J. W. Fay, A. Nademanee, J. H. Antin, N. P. Christiansen, et al. Phase III Study Comparing Methotrexate and Tacrolimus (Prograf, FK506) With Methotrexate and Cyclosporine for Graft-Versus-Host Disease Prophylaxis After HLA-Identical Sibling Bone Marrow Transplantation Blood, October 1, 1998; 92(7): 2303 - 2314. [Abstract] [Full Text] [PDF]