Tacrolimus Versus Cyclosporine for Adult Lung Transplant Recipients: A Meta-Analysis

Fan, Yu; Xiao, Yijun; Weng, Yu-xiong

doi:10.1016/j.transproceed.2008.11.016

Cited by 56 publications

(42 citation statements)

References 11 publications

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“…Experience with immunosuppressive management with tacrolimus for lung transplantation is rapidly accumulating, which shows less acute rejection and less bronchiolitis obliterans syndrome than CyA protocol (37,38). Tacrolimus is not only more effective than CyA, but it is also as safe as CyA (22,36,37). These data on organ transplantation may support the possible advantage of tacrolimus over CyA to treat AE-IPF.…”

Section: Discussionmentioning

confidence: 86%

“…Compared with CyA, posttransplantation immunosuppressive management with tacrolimus improved acute rejection ratio after renal trans-plantation (33)(34)(35), mortality, retransplantation, and treatment failure for immunological reason after liver transplantation (36). Experience with immunosuppressive management with tacrolimus for lung transplantation is rapidly accumulating, which shows less acute rejection and less bronchiolitis obliterans syndrome than CyA protocol (37,38). Tacrolimus is not only more effective than CyA, but it is also as safe as CyA (22,36,37).…”

Section: Discussionmentioning

confidence: 99%

“…These data on organ transplantation may support the possible advantage of tacrolimus over CyA to treat AE-IPF. Although tacrolimus is more diabetogenic (36,37), diabetes is a controllable side effect.…”

Section: Discussionmentioning

confidence: 99%

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Tacrolimus and Steroid Treatment for Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Horita¹,

Akahane²,

Okada³

et al. 2011

Intern. Med.

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Objective Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) occurs during the chronic progressive course of idiopathic pulmonary fibrosis. Mortality is estimated to be >70%, because no effective treatment has been established. We evaluated the effectiveness of combination therapy of tacrolimus and methylprednisolone for AE-IPF. Methods Patients of AE-IPF treated with methylprednisolone pulse therapy with or without tacrolimus (targeting 20 ng/mL) during the period between January 2001 and April 2010 were retrospectively reviewed. The primary endpoints were survival rate and duration. We also observed lactate dehydrogenase levels, partial pressure of arterial oxygen/fraction of inspired oxygen ratio (P/F ratio), KL-6, occurrence of re-exacerbation, and computed tomography score. Results Fifteen Japanese patients [tacrolimus group aged 74.2±6.0 years old (n=5), non-tacrolimus group aged 75.1±12.8 years old (n=10)] were identified. Pre-treatment clinical parameters were not significantly different between the two groups. Four of 5 tacrolimus group patients and 1 of 10 non-tacrolimus group patients survived (p<0.05). The median survival durations were >92 days (tacrolimus group) and 38 days (nontacrolimus group) (p<0.05). Lactate dehydrogenase levels and the P/F ratio were also significantly favorable in the tacrolimus group. KL-6 and CT score were not significantly different in both groups. Four re-acute exacerbations were observed only in the non-tacrolimus group. Conclusion Combined tacrolimus and methylprednisolone pulse therapy mitigates AE-IPF, prevents re-acute exacerbation, and contributes to a better prognosis.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Tacrolimus and Steroid Treatment for Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Horita¹,

Akahane²,

Okada³

et al. 2011

Intern. Med.

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“…Although no data are available for SCT, in the context of solid organ transplantation some reports suggest that tacrolimus can rescue from incipient allograft rejection. 29 It remains uncertain whether tacrolimus may have contributed to this different outcome.…”

Section: Discussionmentioning

confidence: 99%

Escalating doses of donor lymphocytes for incipient graft rejection following SCT for thalassemia

Frugnoli¹,

Cappelli

Chiesa

et al. 2009

Bone Marrow Transplant

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Mixed chimerism (MC) and secondary graft failure are frequent events following SCT for thalassemia. There is limited information regarding the outcome of donor lymphocyte infusion (DLI) to prevent rejection, mainly from case reports describing only successful cases. We describe a series of seven children affected by b-thalassemia treated with escalating doses of DLI for level 2-3 MC (donoro90%) following myeloablative SCT from a matched family donor. The infusions were safe and no acute or chronic GVHD were documented; five patients experienced neutropenia and thrombocytopenia resolving spontaneously. DLI was successful in converting to full donor chimerism two patients stratified in the low-risk class (Pesaro class II). Conversely, for five high-risk patients, DLI was not effective in preventing secondary graft failure. This limited series suggests that escalating doses of DLI are safe in thalassemia patients post myeloablative therapy but efficacy may be jeopardized by rapidly growing antidonor alloimmunity in high-risk patients. We suggest giving escalating doses of donor T cells to attempt a graft-versusthalassemia as soon as level 2-3 MC is detected.

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“…In den meisten Situationen ist zumindest ein Therapieversuch mit β-Blockern indiziert [16]. Bei Bedarf an Katecholaminen und oder Milrinon ist von einer terminalen Herzinsuffizienz auszugehen.…”

Section: Introductionunclassified

Herz- und Lungentransplantation im Kindes- und Jugendalter

Kozlik-Feldmann

Griese

Netz

et al. 2012

Monatsschr Kinderheilkd

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Tacrolimus Versus Cyclosporine for Adult Lung Transplant Recipients: A Meta-Analysis

Cited by 56 publications

References 11 publications

Tacrolimus and Steroid Treatment for Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Tacrolimus and Steroid Treatment for Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Escalating doses of donor lymphocytes for incipient graft rejection following SCT for thalassemia

Herz- und Lungentransplantation im Kindes- und Jugendalter

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