International experience with conversion from cyclosporine to tacrolimus for acute and chronic lung allograft rejection

Abstract Objective A retrospective study involving 13 institutions was performed to assess the efficacy of conversion from cyclosporine (INN: ciclosporin) to tacrolimus. Methods Data from 244 patients were analyzed. Indications for conversion were recurrent-ongoing rejection (n = 110) and stage 1 to 3 bronchiolitis obliterans syndrome (n = 134). Results The incidence of acute rejection decreased significantly within 3 months after versus before the switch from cyclosporine to tacrolimus ( P P = .08 vs zero slope) before and increased by 0.34% of predicted value per month ( P = .32 vs zero slope) after conversion ( P P P P P = 0.04 vs zero slope), respectively. No significant difference in the incidence of infections within 3 months before and after conversion was observed. Conclusions Conversion from cyclosporine to tacrolimus after lung transplantation is associated with reversal of recurrent-ongoing rejection. Conversion for bronchiolitis obliterans syndrome allows short-term stabilization of lung function in most patients.