The Prince Charles Hospital, Brisbane, Australia; 2School of Medicine,. The University of Queensland, Brisbane, Australia. Purpose: Evidence from the liver ...
The Journal of Heart and Lung Transplantation, Vol 32, No 4S, April 2014
Conclusion: Taken together a 1:1 switch from Prograf to Advagraf was safely applied to stable lung transplant recipients. This drug may represent a valid alternative for immunosuppression among long-term lung transplant patients. 1( 70) Erratic Tacrolimus Blood Levels are Associated with Bronchiolitis Obliterans Syndrome (BOS) and Death after Lung Transplantation H.M. Gallagher ,1 G. Sarwar,1 T. Tse,1 T.J. Sladden,2 S.T. Yerkovich,1 P.M. Hopkins,1 D.C. Chambers.1 1Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, Australia; 2School of Medicine, The University of Queensland, Brisbane, Australia. Purpose: Evidence from the liver transplant literature suggests that erratic tacrolimus blood levels (assessed using the standard deviation (SD)) are associated with graft failure. Since this has not been assessed after adult lung transplantation, we aimed to assess the effect of variation in tacrolimus mean and SD on the development of BOS and death. Methods: The medical records of 183 consecutive lung transplant recipients from 1996 - 2013 were retrospectively reviewed. Demographics, tacrolimus trough blood levels, BOS status and survival were recorded for each patient. Univariate and multivariate survival analyses were used to investigate the effect of tacrolimus mean and SD on survival and BOS. Results: 183 patients (93 Female, 85% bilateral, 42% CF, 33% COPD, 9% IPF, median age at transplant 46.6 years) were reviewed. At census 103 (56%) patients were BOS grade 1 or greater and 71 (39%) deceased. Tacrolimus SD was the greatest over the first 6 months (median (IQR) 4.08 (3.05-5.98) compared to 6-12 months (2.88 (2.15-4.24), p