TY - JOUR
T1 - Prolonged administration of twice-daily bolus intravenous tacrolimus in the early phase after lung transplantation
AU - Hirano, Yutaka
AU - Sugimoto, Seiichiro
AU - Mano, Toshifumi
AU - Kurosaki, Takeshi
AU - Miyoshi, Kentaroh
AU - Otani, Shinji
AU - Yamane, Masaomi
AU - Kobayashi, Motomu
AU - Miyoshi, Shinichiro
AU - Oto, Takahiro
N1 - Funding Information:
Presented at the 36th annual meeting and scientific sessions of the International Society for Heart and Lung Transplantation, Washington, DC, USA, April 2016 Seiichiro Sugimoto, e-mail: sugimo-s@cc.okayama-u.ac.jp This work was supported by grant-in-aid for Scientific Research grant no. 15K10256 from the Japan Society for the Promotion of Science
Publisher Copyright:
© Ann Transplant, 2017.
PY - 2017
Y1 - 2017
N2 - 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/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 followup 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.
AB - 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/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 followup 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.
KW - Acute kidney injury
KW - Administration, intravenous
KW - Graft rejection
KW - Immunosuppression
KW - Lung transplantation
KW - Tacrolimus
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U2 - 10.12659/AOT.904225
DO - 10.12659/AOT.904225
M3 - Article
C2 - 28798289
AN - SCOPUS:85029514926
VL - 22
SP - 484
EP - 492
JO - Annals of Transplantation
JF - Annals of Transplantation
SN - 1425-9524
ER -