Despite the widespread use of potent immunosuppressive drugs,
such as cyclosporin A and mycophenolate mofetil, ongoing and
recurrent cellular rejection remain a common problem after heart
transplantation. We aimed to describe the long-term effects of
conversion from cyclosporine A to tacrolimus in patients with
ongoing and recurrent cellular rejection. This was a single-centre
retrospective analysis of 17 heart transplant recipients who were
switched from cyclosporine A to tacrolimus due to ongoing
(5 patients) or recurrent cellular rejection (12 patients). We
studied long-term efficacy and safety of this approach. 167
endomyocardial biopsies were performed during a mean followup of 69.1±12.7 months. Thirteen biopsies (7.8 %) in eight
patients (47 %) revealed higher grades of acute cellular rejection
(Banff 2). However, they were not hemodynamically significant
and did not require intravenous antirejection therapy. The mean
rejection score was reduced significantly. Conversion to
tacrolimus was tolerated in 82 % pts without any significant side
effects during a long-term follow-up. In conclusion, the
conversion to tacrolimus in heart transplant recipients with
ongoing or recurrent acute cellular rejection was safe and
effective also during a long-term follow-up.
Long-Term Efficacy and Safety of Conversion to Tacrolimus in Heart
Transplant Recipients with Ongoing or Recurrent Acute Cellular
Rejection
