Cited by 108Transplantation: Methods and OutcomesRenal Transplantation Outcomes and TreatmentsOrgan and Tissue Transplantation Research

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Tacrolimus versus cyclosporine after lung transplantation: a prospective, open, randomized two-center trial comparing two different immunosuppressive protocols

Treede, Hendrik, Klepetko, Walter, Reichenspurner, Hermann, Zuckermann, Andreas, Meiser, Bruno, Birsan, Tudor, Wisser, Wilfried, Reichert, Bruno·2001·The Journal of Heart and Lung Transplantation

DOI 10.1016/s1053-2498(01)00244-3

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Abstract

Background The need for better immunosuppressive protocols after lung transplantation led us to investigate tacrolimus (Tac) in combination with mycophenolate mofetil (MMF) and steroids or cyclosporine (CsA) in combination with MMF and steroids in a prospective, open, randomized trial after lung transplantation. Methods Between September 1997 and April 1999, 50 lung transplant recipients were randomized to receive either Tac (n = 26) or CsA (n = 24) in combination with MMF and steroids. All patients underwent induction therapy with rabbit antithymocyte globulin (ATG) for 3 days. Freedom from acute rejection (AR), patient survival, infection episodes, and side effects were monitored. Results There was no difference in patient demographics between the two groups. Six-month and 1-year survival was similar (84.6% and 73.1% in the Tac group vs 83.3% and 79.2% in the CsA group). Freedom from AR at 6 months and 1 year after lung transplantation was slightly higher in the Tac group (57.7% and 50% vs 45.8% and 33.3%, p = not significant [n.s.]), whereas the number of treated rejection episodes per 100 patient days in the Tac group was significantly lower (0.225 vs 0.426, p < .05). Four patients in the CsA group had to be switched to Tac. Two patients in the CsA group had to be retransplanted. Incidence of infections was similar in both groups with a trend toward more fungal infections in the Tac group (n = 7 vs n = 1, p = n.s.). Conclusions The combination of Tac and MMF seems to have slightly higher immunosuppressive potential compared with CsA and MMF. The effectiveness of Tac as a rescue agent is not paralleled with undue signs of overimmunosuppression.

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Authors: Treede, H., Klepetko, W., Reichenspurner, H., Zuckermann, A., Meiser, B., Birsan, T., Wisser, W., & Reichert, B.
Affiliations: Ludwig-Maximilians-Universität München (DE)
University of Vienna (AT)
Corresponding author: Reichenspurner, Hermann
ORCID: Treede, Hendrik
Klepetko, Walter
Zuckermann, Andreas
Wisser, Wilfried
Venue: The Journal of Heart and Lung Transplantation
Publisher: Elsevier BV
Published: 2001-05
Volume: 20
Issue: 5
Pages: 511-517
ISSN: 1053-2498 (ISSN-L)
DOI: 10.1016/s1053-2498(01)00244-3
OpenAlex: W1970749259
Cited by: 108
References: 21
Citations by year: 2026: 2 · 2025: 4 · 2024: 1 · 2023: 8 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 4 · 2015: 1 · 2014: 5 · 2013: 4 · 2012: 5
FWCI: 6.62
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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, immunosuppressive therapy, mycophenolate mofetil, acute rejection, patient survival, infection incidence, fungal infection, induction therapy, antithymocyte globulin
MeSH terms: Acute Disease, Adult, Aged, Bronchiolitis Obliterans, Chronic Disease, Creatinine, Drug Combinations, Female, Follow-Up Studies, Graft Rejection, Humans, Immunosuppressive Agents, Infections, Male, Middle Aged, Mycophenolic Acid, Prospective Studies, Time Factors, Incidence, Survival Rate, Lung Transplantation, Tacrolimus, Cyclosporine, Treatment Outcome

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Tacrolimus versus cyclosporine after lung transplantation: a prospective, open, randomized two-center trial comparing two different immunosuppressive protocols

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