11 August 2017 : Original article
Prolonged Administration of Twice-Daily Bolus Intravenous Tacrolimus in the Early Phase After Lung TransplantationYutaka Hirano1ADEF, Seiichiro Sugimoto1ABCDEFG*, Toshifumi Mano1BCD, Takeshi Kurosaki2BCD, Kentaroh Miyoshi1ABC, Shinji Otani2ABC, Masaomi Yamane1ABC, Motomu Kobayashi3ABC, Shinichiro Miyoshi1ABC, Takahiro Oto2ABCDEF
Ann Transplant 2017; 22:484-492
BACKGROUND: Although administration of tacrolimus, whether by the enteric, sublingual, or continuous intravenous routes, has some limitations, twice-daily bolus intravenous tacrolimus administration has been shown to be beneficial in optimizing efficacy and safety after lung transplantation. However, at present, the duration of bolus intravenous tacrolimus administration is limited, and the effects of prolonged bolus intravenous tacrolimus administration remain unknown. Our study was aimed at assessing the safety and efficacy of prolonged twice-daily bolus intravenous tacrolimus administration in the early phase after lung transplantation.
MATERIAL AND METHODS: We retrospectively investigated the data of 62 recipients of lung transplantation who had received twice-daily bolus intravenous administration of tacrolimus, followed by oral tacrolimus, after lung transplantation at our institution between January 2011 and October 2015.
RESULTS: The median duration of bolus intravenous tacrolimus administration was 19 days (4–72 days). The target trough level was achieved in 89% of the patients by day 3. Acute kidney injury occurred in 27% of the patients during bolus intravenous tacrolimus. Two patients (3%) had neurotoxicity, necessitating discontinuation of tacrolimus. Suspected acute rejection requiring steroid pulse therapy occurred in 21% of patients during the follow-up period. Eight patients (13%) developed chronic lung allograft dysfunction during the follow-up period. The 1-year and 5-year survival rates after lung transplantation were 95% and 76%, respectively.
CONCLUSIONS: These results suggest that prolonged bolus intravenous tacrolimus administration in the early phase after lung transplantation is a safe and effective alternative to enteric, sublingual, or continuous intravenous administration.
Keywords: Administration, Intravenous, Graft Rejection, Immunosuppression, Lung Transplantation, Tacrolimus
04 Aug 2022 : Original articleLong-Term Patency of All-in-One Sleeve Patch Graft Venoplasty in 16 Patients Who Underwent Living Donor Liv...
Ann Transplant In Press; DOI: 10.12659/AOT.936888
22 Jul 2022 : Original articleDiagnostic Role of Tumor Markers for Hepatocellular Carcinoma in Liver Transplantation Candidates: An Analy...
Ann Transplant In Press; DOI: 10.12659/AOT.936937
22 Jul 2022 : Original articleDevelopment of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-R...
Ann Transplant In Press; DOI: 10.12659/AOT.936732
Most Viewed Current Articles
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
24 Jul 2020 : Review articleKidney Transplantation in the Times of COVID-19 – A Literature Review
Ann Transplant 2020; 25:e925755