August 17, 2012

Tacrolimus and cyclosporine have differential effects on the risk of development of bronchiolitis obliterans syndrome: Results of a prospective, randomized international trial in lung transplantation


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Immunosuppression regimens after lung transplantation are typically based on calcineurin inhibitors. Tacrolimus is widely used as an alternative to cyclosporine, and it has been proposed that tacrolimus may reduce the development of bronchiolitis obliterans (BOS) when compared to cyclosporine. This randomized, open-label, multicenter trial compared cyclosporine to tacrolimus (both plus prednisolone and mycophenolate mofetil) for the prevention of BOS in 249 lung and heart-lung transplant recipients. At 3 years, there was a lower cumulative incidence of BOS in the tacrolimus group (11.6% vs. 21.3%), although the study may have been underpowered due to a large number of patients switched to different immunosuppressive protocols during the study period. There was no difference in side effects, infections, or survival between the groups. There was a trend towards worsened renal function in the tacrolimus group.

Lung Transplantation

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