THE USE OF TACROLIMUS IN RENAL-TRANSPLANTATION

Tacrolimus (FK 506) is a novel immunosuppressive agent that has been i n clinical use for solid organ transplantation since 1989. Early clini cal trials of tacrolimus in liver, heart, kidney, lung, and intestinal transplantation at the University of Pittsburgh have demonstrated it to be a safe and effective agent with several potential advantages ove r existing immunosuppressive drugs. More recently, phase I and II mult icenter trials of tacrolimus for renal transplantation have been perfo rmed; however, data are not yet available from these trials. Our exper ience with this drug has demonstrated excellent 1- and 2-year actuaria l graft survival rates of 89% and 83%, respectively, in adult renal tr ansplantation and 1- and 3-year graft survival rates of 98% and 85%, r espectively in pediatric renal transplantation. A major advantage of t acrolimus noted in these trials was the ability to discontinue steroid therapy in approximately 50% of the patients. Tacrolimus has also sho wn efficacy as a rescue agent for renal allograft rejection failing co nventional therapy in 74% of cases. This paper expands on these observ ations and focuses on the experience we have gained with the use of ta crolimus at our institution over the last 6 years.