Solid Organ Transplantation: The LungClinical Use and Bioavailability of Tacrolimus in Heart-Lung and Double Lung Transplant Recipients With Cystic Fibrosis
Section snippets
Patients and Methods
Between September 1993 and April 1996, eight patients (four male) with CF were converted from cyclosporine to tacrolimus because of recurrent acute rejection or the development of bronchiolitis obliterans syndrome after lung transplantation. These patients were compared to 12 non-CF lung transplant patients (four male) who were also converted to tacrolimus during the same period. The indications for transplantation in the non-CF group were respiratory failure due to emphysema (7), cryptogenic
Results
The duration of follow up was 326 days (range, 120–689) in the CF group and 436 days (range, 155–714) in the non-CF group. The tacrolimus blood concentration achieved (12-hour trough level) was similar in the two groups: 10.3 ± 2.6 ng/mL in the CF group and 10.7 ± 1.6 ng/mL in the non-CF group. The mean daily dose was 7.9 ± 2.8 mg in the CF group and 6.4 ± 3.7 mg in the non-CF group (P = .14). The CF patients tended to have a lower body weight at 50.9 ± 5.4 kg compared with 57.4 ± 10.6 kg in
Discussion
Transfer of CF patients from cyclosporine to tacrolimus was achieved without difficulty. Immediately after discontinuing cyclosporine tacrolimus was started at a dose of approximately 100 μg/kg/d (divided into 2 doses) and subsequently the dose was titrated to achieve the target blood level. The total dose required in the CF patients was only slightly higher than that in the non-CF patients. When the lower body weight of the CF patients was taken into account, however, the dose required was 39%
References (4)
- et al.
Eur J Clin Pharmacol
(1994) - et al.
Transplant Proc
(1994)