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Ann Thorac Surg 1995;60:495-496
© 1995 The Society of Thoracic Surgeons

Editorials

Advantage-FK 506: Reduced Chronic Rejection for Lung Transplant Recipients

R. Morton Bolman, III, MD

Division of Cardiovascular and Thoracic Surgery, University of Minnesota, Minneapolis, MN

The first 20% of the full text of this article appears below.

Cyclosporine has been the mainstay of immunosuppressive regimens for solid-organ transplantation since its introduction in 1981. This agent is largely responsible for the explosive growth in solid-organ transplantation that has occurred in the ensuing 15 years. The initial success of transplantation of the liver, pancreas, heart/lung, and lung has been attributed to cyclosporine. In addition, cyclosporine is credited with markedly improving outcomes in kidney and heart transplantation. We have learned much about this agent with respect to toxicity, dosing, and combination therapies of cyclosporine and other immunosuppressive agents. Because the lung is the most recent organ to be successfully transplanted, cyclosporine-based immunosuppressive regimens established for other organs, most commonly the heart, have been applied with some modifications to lung transplantation [1, 2]. As in all fields of medicine, progress continues and, in transplantation, the golden grail remains the agent(s) that will induce tolerance to the transplanted organ without impairing host defenses.

See also page 580.

Although cyclosporine-based immunosuppression has clearly enhanced both patient and graft survival in all solid-organ transplants compared with the era of azathioprine and steroids, many centers still report a high incidence of rejection in cyclosporine-treated patients. The enhanced immunosuppressive therapy necessary to control such rejection, primarily in the form of steroids and antilymphocyte preparations, conspire to increase the risk of infectious complications. Therefore, any agent that may lead to a lower incidence of graft rejection would be very beneficial from the standpoint of both graft survival and patient survival . . . [Full Text of this Article]


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Clinical Trial of Tacrolimus Versus Cyclosporine in Lung Transplantation
Robert J. Keenan, Heroaki Konishi, Akihiko Kawai, Irvin L. Paradis, David R. Nunley, Aldo T. Iacono, Robert L. Hardesty, Robert J. Weyant, and Bartley P. Griffith
Ann. Thorac. Surg. 1995 60: 580-584. [Abstract] [Full Text]





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