Tacrolimus and mycophenolate mofetil as first line immunosuppression after lung transplantation

  1. Claus Neurohr1,†,
  2. Patrick Huppmann1,†,
  3. Gregor Zimmermann1,
  4. Hanno Leuchte1,
  5. Rainer Baumgartner1,
  6. Rudolf Hatz2,
  7. Lorenz Frey3,
  8. Peter Überfuhr4,
  9. Iris Bittmann5,
  10. Jürgen Behr1,
  11. Bruno Reichart4,
  12. for the Munich Lung Transplant Group1

Article first published online: 2 FEB 2009

DOI: 10.1111/j.1432-2277.2009.00843.x

Issue

Transplant International

Transplant International

Volume 22, Issue 6, pages 635–643, June 2009

Additional Information

How to Cite

Neurohr, C., Huppmann, P., Zimmermann, G., Leuchte, H., Baumgartner, R., Hatz, R., Frey, L., Überfuhr, P., Bittmann, I., Behr, J., Reichart, B. and for the Munich Lung Transplant Group (2009), Tacrolimus and mycophenolate mofetil as first line immunosuppression after lung transplantation. Transplant International, 22: 635–643. doi: 10.1111/j.1432-2277.2009.00843.x

Author Information

  1. 1

     Department of Int. Medicine I, Division of Pulmonary Diseases, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany

  2. 2

     Department of Surgery and Thoracic Surgery, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany

  3. 3

     Department of Anesthesiology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany

  4. 4

     Department of Cardiac Surgery, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany

  5. 5

     Institute of Pathology, Ludwig-Maximilians University, Munich, Germany

  1. †

    These authors contributed equally.

*Claus Neurohr MD, Department of Internal Medicine I, Division for Pulmonary Diseases, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Marchioninistrasse 15, 81377 Munich, Germany. Tel.: +49 89 7095 3071; fax: +49 89 7095 8877; e-mail: claus.neurohr@med.uni-muenchen.de

Publication History

  1. Issue published online: 7 MAY 2009
  2. Article first published online: 2 FEB 2009
  3. Received: 26 October 2008 Revision requested: 15 December 2008 Accepted: 8 January 2009

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Keywords:

  • lung transplantation;
  • mycophenolate mofetil;
  • survival;
  • tacrolimus

Summary

The optimal maintenance therapy after lung transplantation remains to be established. The aim of this study was to analyse the impact of tacrolimus and mycophenolate mofetil (MMF) as first line immunosuppression on long-term survival and Bronchiolitis Obliterans Syndrome (BOS). From January 1996 through December 2006, all 155 recipients receiving tacrolimus and MMF as maintenance immunosuppression were included in this study. Tacrolimus and MMF was discontinued in 36 patients (23.2%). The overall survival rates were 91.6% at 6 months, 86.4% at 1 year, 74.9% at 3 years, 60.3% at 5 years and 32.4% at 10 years. The overall freedom from acute rejection was 74.6%, 63.2% and 59.4% at 1, 3, and 5 years respectively. The overall BOS-free survival was 95.6% at 1 year, 88.4% at 3 years, 69.5% at 5 years and 30.5% at 10 years. The development of BOS ≥ 1 was associated with a significantly increased risk of death and reduced long-term survival. The combination of tacrolimus and MMF offers safe and reliable maintenance immunosuppression after lung transplantation. However, substantial improvements of long-term survival and freedom from BOS might only be achieved by a change in organ allocation policies and patient management beyond differential immunosuppressive protocols.

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