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Clinical trial of FK 506 immunosuppression in adult cardiac transplantation

Armitage, JM and Kormos, RL and Morita, S and Fung, J and Marrone, GC and Hardesty, RL and Griffith, BP and Starzl, TE (1992) Clinical trial of FK 506 immunosuppression in adult cardiac transplantation. The Annals of Thoracic Surgery, 54 (2). 205 - 211. ISSN 0003-4975

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Abstract

The new immunosuppressive agent FK 506 was used as primary immunotherapy in conjunction with low-dose steroids and azathioprine in 72 patients subsequent to orthotopic cardiac transplantation. Overall patient survival at a mean follow-up of 360 days was 92%. The number of episodes of cardiac rejection (grade 3A or greater) within 90 days of transplantation was 0.95 per patient. The actuarial freedom from rejection at 90 days was 41%. Achievement of this level of immunosuppression is comparable with that of cyclosporine-based triple-drug therapy with OKT3 immunoprophylaxis. Thirty percent of patients were tapered off all steroids, and the average steroid dose in the group who received steroids was 8.6 mg of prednisone per day. The incidence of infection reflected the diminished necessity for steroids: seven major infections (10%) and 11 minor infections (16%). Renal dysfunction occurred during the perioperative period in most patients in this trial. However, the incidence of hypertension was 54% compared with 70% during the cyclosporine era. Ten adults underwent successful rescue therapy with FK 506 after cardiac rejection refractory to conventional immunotherapy. Side effects of FK 506 were notably few, and the results of the trial are encouraging for the future of the cardiac transplant recipient. © 1992.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Armitage, JM
Kormos, RLkormos@pitt.eduKORMOS
Morita, S
Fung, J
Marrone, GC
Hardesty, RL
Griffith, BP
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1992
Date Type: Publication
Journal or Publication Title: The Annals of Thoracic Surgery
Volume: 54
Number: 2
Page Range: 205 - 211
DOI or Unique Handle: 10.1016/0003-4975(92)91371-f
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0003-4975
Other ID: uls-drl:31735062111962, Starzl CV No. 1402
Date Deposited: 08 Apr 2010 17:23
Last Modified: 03 Feb 2019 04:55
URI: http://d-scholarship.pitt.edu/id/eprint/4788

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