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[Is tacrolimus effective for ongoing renal allograft rejection?]
T Nishioka1, M Imanishi, T Akiyama
1Department of Urology, Kinki University School of Medicine.
Hinyokika Kiyo. Acta Urologica Japonica
|July 10, 1998
Summary
Tacrolimus rescue therapy shows effectiveness against acute rejection after kidney transplants. However, its efficacy in preventing chronic rejection requires further investigation and longer patient follow-up.
Area of Science:
- Nephrology
- Immunology
- Transplantation Medicine
Context:
- Tacrolimus is a well-established immunosuppressant for kidney transplant recipients.
- Its use as rescue therapy for rejection is gaining traction.
- Cyclosporine-based immunosuppression was the initial treatment for the study cohort.
Purpose:
- To evaluate the efficacy of Tacrolimus as a rescue therapy for kidney transplant rejection.
- To assess Tacrolimus effectiveness across different rejection types: acute (AR), late-onset acute (LAR), and chronic (CR).
Summary:
- The study analyzed 19 kidney transplant patients experiencing rejection under cyclosporine therapy.
- Tacrolimus rescue therapy demonstrated satisfactory long-term outcomes in acute rejection cases, often with combination therapy.
- Efficacy was observed in 50% of late-onset acute rejection patients, with target trough levels of 10-15 ng/ml.
- For chronic rejection, Tacrolimus prevented deterioration in 50% of patients observed for less than one year, with lower trough levels (5-10 ng/ml), but was ineffective in those observed longer.
Impact:
- Tacrolimus rescue therapy is effective for acute rejection episodes post-kidney transplantation.
- Further research is necessary to determine the long-term impact and optimal dosing of Tacrolimus for chronic rejection.
- These findings contribute to optimizing immunosuppressive strategies in kidney transplantation.