Suggested guidelines for the use of tacrolimus in pancreas/kidney transplantation

Rainer W G Gruessner, Stephen T. Bartlett, George W Burke, Peter G. Stock

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

As experience with tacrolimus (FK506, Prograf®) accumulates and reduced rejection rates are increasingly demonstrated, some transplant centers are adopting tacrolimus-based primary immunosuppressive regimens for their patients undergoing pancreas/kidney transplantation. The guidelines provided in this article based on the experience of four major US transplant centers, cover issues related to dosing, blood levels, concomitant use of mycophenolate mofetil (MMF), antifungal and antiviral prophylaxis, and drug interactions. For post-transplant immunosuppression some centers initiate oral tacrolimus administration on postoperative day 1, 2, or 3, while others wait until day 6 or 7, when renal or gastrointestinal function has resumed. Most centers endeavor to achieve higher target trough levels (~ 10-20 ng/mL, but not higher) in the first 3 months post-transplant, reducing levels thereafter. Several centers are now using MMF instead of azathioprine as an adjunct to tacrolimus. Conversion from cyclosporine to tacrolimus during maintenance therapy is often considered in the event of rejection or when adverse events do not respond to dosage reduction.

Original languageEnglish
Pages (from-to)260-262
Number of pages3
JournalClinical Transplantation
Volume12
Issue number3
StatePublished - Jun 1 1998

Fingerprint

Pancreas Transplantation
Tacrolimus
Kidney Transplantation
Guidelines
Mycophenolic Acid
Transplants
Azathioprine
Immunosuppressive Agents
Drug Interactions
Immunosuppression
Cyclosporine
Antiviral Agents
Oral Administration
Kidney

Keywords

  • Pancreas/kidney transplantation
  • Tacrolimus

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Gruessner, R. W. G., Bartlett, S. T., Burke, G. W., & Stock, P. G. (1998). Suggested guidelines for the use of tacrolimus in pancreas/kidney transplantation. Clinical Transplantation, 12(3), 260-262.

Suggested guidelines for the use of tacrolimus in pancreas/kidney transplantation. / Gruessner, Rainer W G; Bartlett, Stephen T.; Burke, George W; Stock, Peter G.

In: Clinical Transplantation, Vol. 12, No. 3, 01.06.1998, p. 260-262.

Research output: Contribution to journalArticle

Gruessner, RWG, Bartlett, ST, Burke, GW & Stock, PG 1998, 'Suggested guidelines for the use of tacrolimus in pancreas/kidney transplantation', Clinical Transplantation, vol. 12, no. 3, pp. 260-262.
Gruessner, Rainer W G ; Bartlett, Stephen T. ; Burke, George W ; Stock, Peter G. / Suggested guidelines for the use of tacrolimus in pancreas/kidney transplantation. In: Clinical Transplantation. 1998 ; Vol. 12, No. 3. pp. 260-262.
@article{86a988db10264a7fb688fa22fbd0cc5a,
title = "Suggested guidelines for the use of tacrolimus in pancreas/kidney transplantation",
abstract = "As experience with tacrolimus (FK506, Prograf{\circledR}) accumulates and reduced rejection rates are increasingly demonstrated, some transplant centers are adopting tacrolimus-based primary immunosuppressive regimens for their patients undergoing pancreas/kidney transplantation. The guidelines provided in this article based on the experience of four major US transplant centers, cover issues related to dosing, blood levels, concomitant use of mycophenolate mofetil (MMF), antifungal and antiviral prophylaxis, and drug interactions. For post-transplant immunosuppression some centers initiate oral tacrolimus administration on postoperative day 1, 2, or 3, while others wait until day 6 or 7, when renal or gastrointestinal function has resumed. Most centers endeavor to achieve higher target trough levels (~ 10-20 ng/mL, but not higher) in the first 3 months post-transplant, reducing levels thereafter. Several centers are now using MMF instead of azathioprine as an adjunct to tacrolimus. Conversion from cyclosporine to tacrolimus during maintenance therapy is often considered in the event of rejection or when adverse events do not respond to dosage reduction.",
keywords = "Pancreas/kidney transplantation, Tacrolimus",
author = "Gruessner, {Rainer W G} and Bartlett, {Stephen T.} and Burke, {George W} and Stock, {Peter G.}",
year = "1998",
month = "6",
day = "1",
language = "English",
volume = "12",
pages = "260--262",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Suggested guidelines for the use of tacrolimus in pancreas/kidney transplantation

AU - Gruessner, Rainer W G

AU - Bartlett, Stephen T.

AU - Burke, George W

AU - Stock, Peter G.

PY - 1998/6/1

Y1 - 1998/6/1

N2 - As experience with tacrolimus (FK506, Prograf®) accumulates and reduced rejection rates are increasingly demonstrated, some transplant centers are adopting tacrolimus-based primary immunosuppressive regimens for their patients undergoing pancreas/kidney transplantation. The guidelines provided in this article based on the experience of four major US transplant centers, cover issues related to dosing, blood levels, concomitant use of mycophenolate mofetil (MMF), antifungal and antiviral prophylaxis, and drug interactions. For post-transplant immunosuppression some centers initiate oral tacrolimus administration on postoperative day 1, 2, or 3, while others wait until day 6 or 7, when renal or gastrointestinal function has resumed. Most centers endeavor to achieve higher target trough levels (~ 10-20 ng/mL, but not higher) in the first 3 months post-transplant, reducing levels thereafter. Several centers are now using MMF instead of azathioprine as an adjunct to tacrolimus. Conversion from cyclosporine to tacrolimus during maintenance therapy is often considered in the event of rejection or when adverse events do not respond to dosage reduction.

AB - As experience with tacrolimus (FK506, Prograf®) accumulates and reduced rejection rates are increasingly demonstrated, some transplant centers are adopting tacrolimus-based primary immunosuppressive regimens for their patients undergoing pancreas/kidney transplantation. The guidelines provided in this article based on the experience of four major US transplant centers, cover issues related to dosing, blood levels, concomitant use of mycophenolate mofetil (MMF), antifungal and antiviral prophylaxis, and drug interactions. For post-transplant immunosuppression some centers initiate oral tacrolimus administration on postoperative day 1, 2, or 3, while others wait until day 6 or 7, when renal or gastrointestinal function has resumed. Most centers endeavor to achieve higher target trough levels (~ 10-20 ng/mL, but not higher) in the first 3 months post-transplant, reducing levels thereafter. Several centers are now using MMF instead of azathioprine as an adjunct to tacrolimus. Conversion from cyclosporine to tacrolimus during maintenance therapy is often considered in the event of rejection or when adverse events do not respond to dosage reduction.

KW - Pancreas/kidney transplantation

KW - Tacrolimus

UR - http://www.scopus.com/inward/record.url?scp=0031836202&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031836202&partnerID=8YFLogxK

M3 - Article

VL - 12

SP - 260

EP - 262

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 3

ER -