The DOI matches its Crossref record; 27 of the 27 references it cites were found in a registry or an index.
A Randomized Controlled Trial of Tacrolimus Versus Cyclosporine After Lung Transplantation
Abstract
Background The optimal maintenance immunosuppressive regimen after lung transplantation is uncertain. Methods We conducted a randomized controlled trial of tacrolimus versus cyclosporine in combination with azathioprine and prednisone after lung transplantation. Ninety adults were randomized to tacrolimus (n = 44) or cyclosporine (n = 46). The primary end point was a composite of a cumulative acute rejection A score of 3 or higher, a cumulative lymphocytic bronchitis B score of 4 or higher, or the onset of bronchiolitis obliterans syndrome (BOS) stage 0-p. Results Recipients randomized to cyclosporine were significantly more likely to develop the primary end point than those randomized to tacrolimus. During the study period, the primary end point developed in 39 of 46 cyclosporine subjects compared with 24 of 44 tacrolimus subjects (p = 0.002); acute rejection or lymphocytic bronchitis end points developed in 29 of 46 cyclosporine subjects compared with 18 of 44 tacrolimus subjects (p = 0.036). Furthermore, BOS stage 0-p was more likely to develop in the cyclosporine group than in the tacrolimus group, but this was not statistically significant (log-rank p = 0.1). In addition, there was a trend to a higher incidence of diabetes among those in the tacrolimus group, but there was no significant difference in graft survival or the total number of infections, or in the incidence of hypertension, chronic kidney disease, or cancer between the 2 groups. Conclusions Tacrolimus is associated with a lower burden of acute rejection and lymphocytic bronchitis and a trend to a greater freedom from BOS stage 0-p than cyclosporine after lung transplantation.
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“This finding is plausible, as cyclosporine-based immunosuppressive regimens have been shown to be inferior to tacrolimus-based therapy, with higher rates of acute cellular rejection and increased CLAD incidence.16, 17, 18, 19, 20”
From Lung retransplantation during the Lung Allocation Score era: Outcomes from a large single center (2026) · cites this paper as [18]
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Cites
Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria
Estenne, M., MAURER, J. R., Boehler, A., Egan, J. J., Frost, A., Hertz, M. I., Mallory, G. B., Snell, G. I., & Yousem, S. A. (2002) · The Journal of Heart and Lung Transplantation · doi:10.1016/s1053-2498(02)00398-4 · Cited by 1,276
Eisen, H. J., Tuzcu, E. M., Dorent, R., KOBASHIGAWA, J. A., MANCINI, D. M., Valantine, H. A., Starling, R. C., Sørensen, K. E., Hummel, M. W., Lind, J. M., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022171 · Cited by 1,194
Yousem, S. A., Berry, G. J., Cagle, P. T., Chamberlain, D. W., Husain, A. N., Hruban, R. H., Marchevsky, A. M., Ohori, N. P., Ritter, J. M., Stewart, S., et al. (1996) · PubMed · Cited by 842
Composite Outcomes in Randomized Trials
Freemantle, N., Calvert, M., Wood, J., Eastaugh, J., & Griffin, C. (2003) · JAMA · doi:10.1001/jama.289.19.2554 · Cited by 798
Risk factors for bronchiolitis obliterans: a systematic review of recent publications
Sharples, L. D., McNeil, K., Stewart, S., & Wallwork, J. L. (2002) · The Journal of Heart and Lung Transplantation · doi:10.1016/s1053-2498(01)00360-6 · Cited by 347
Trulock, E. P., Edwards, L. B., Taylor, D. O., Boucek, M. M., Keck, B. M., & Hertz, M. I. (2006) · The Journal of Heart and Lung Transplantation · doi:10.1016/j.healun.2006.06.001 · Cited by 271
Self-citationAnalysis of Risk Factors for the Development of Bronchiolitis Obliterans Syndrome
Husain, A. N., Siddiqui, M. T., HOLMES, E. W., Chandrasekhar, A. J., McCabe, M., RADVANY, R. M., & Garrity, E. R. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.3.9607099 · Cited by 267
Clinical trial of tacrolimus versus cyclosporine in lung transplantation
Keenan, R. J., Konishi, H., Kawai, A., Paradis, I. L., Nunley, D. R., Iacono, A. T., Hardesty, R. L., Weyant, R. J., & GRIFFITH, B. P. (1995) · The Annals of Thoracic Surgery · doi:10.1016/0003-4975(95)00407-c · Cited by 219
King, M. B., Dunitz, J., Park, S. J., Savik, S. K., & Hertz, M. I. (2003) · Transplantation · doi:10.1097/01.tp.0000064083.02120.2c · Cited by 209
Groetzner, J., Kur, F., Spelsberg, F. W., Behr, J., Frey, L., Bittmann, I., Vogeser, M., Ueberfuhr, P., Meiser, B., Hatz, R. A., et al. (2004) · The Journal of Heart and Lung Transplantation · doi:10.1016/s1053-2498(03)00309-7 · Cited by 176
Research works printed but not linked: 1
- McCurry, 2002, Long term follow-up of a prospective randomized trial of tacrolimus versus cyclosporine in human lung transplantation [abstract 87], Am J Transplant, 2, 159
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Sorted by citations
Chronic Lung Allograft Rejection: Mechanisms and Therapy
Belperio, J. A., WEIGT, S. S., Fishbein, M. C., & Lynch, J. P. (2009) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200807-073go · Cited by 205
Self-citationAcute Rejection and Humoral Sensitization in Lung Transplant Recipients
Martinu, T., Chen, D.-F., & Palmer, S. M. (2009) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200808-080go · Cited by 174
Short- and long-term outcomes of 1000 adult lung transplant recipients at a single center
Kreisel, D., Krupnick, A. S., Puri, V., Guthrie, T. J., Trulock, E. P., Meyers, B. F., & Patterson, G. A. (2010) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2010.09.009 · Cited by 146
Self-citationImmunosuppression in lung transplantation.
Scheffert, J. L., & Raza, K. (2014) · PubMed Central · doi:10.3978/j.issn.2072-1439.2014.04.23 · Cited by 140
Nelson, J., Alvey, N., Bowman, L., Schulte, J., Segovia, M. C., McDermott, J., Te, H. S., Kapila, N., Levine, D. J., Gottlieb, R. L., et al. (2022) · Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.2716 · Cited by 130
Metadata
- Authors
- Hachem, R. R., Yusen, R. D., Chakinala, M. M., Meyers, B. F., Lynch, J. P., Aloush, A. A., Patterson, G. A., & Trulock, E. P.
- Affiliations
- Washington University in St. Louis (US)
- ORCID
- Venue
- The Journal of Heart and Lung Transplantation
- Publisher
- Elsevier BV
- Published
- 2007-10
- Volume
- 26
- Issue
- 10
- Pages
- 1012-1018
- ISSN
- 1053-2498 (ISSN-L)
- OpenAlex
- W2082707670
- Cited by
- 160
- References
- 27
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 8 · 2023: 18 · 2022: 8 · 2021: 9 · 2020: 8 · 2019: 3 · 2018: 12 · 2017: 6 · 2016: 6 · 2015: 2 · 2014: 9 · 2013: 7 · 2012: 6
- FWCI
- 10.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Heart and Lung Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
- Keywords
- tacrolimus, cyclosporine, lung transplantation, maintenance immunosuppression, acute rejection, bronchiolitis obliterans syndrome, azathioprine, prednisone, diabetes mellitus, graft survival
- MeSH terms
- Adult, Azathioprine, Bronchiolitis Obliterans, Bronchitis, Diabetes Mellitus, Drug Therapy, Combination, Female, Graft Rejection, Graft Survival, Humans, Immunosuppressive Agents, Male, Middle Aged, Postoperative Care, Lung Transplantation, Tacrolimus, Cyclosporine
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