Background: Our positive experience with tacrolimus (FK 506) in heart trans
plantation has led to our assessing the use of this medication as a primary
immunosuppressant in lung transplantation. 62 of our patients after lung t
ransplantation were included in this study. The first 34 patients were trea
ted with cyclosporine A (CyA), the remaining 28 with tacrolimus. No meaning
ful differences were found in baseline characteristics. The actuarial one-y
ear survival rate was 70.6% for the CyA group and 92.3% for the tacrolimus
group. The number of acute rejection episodes per patient was 1.50 for the
CyA group versus 1.18 for the tacrolimus group (p < 0.05). The incidence of
infection and their spectrum were comparable in both groups. The most freq
uently reported adverse events were diabetes mellitus 57% (tacrolimus) vs 2
3% (CyA), and renal insufficiency (27% vs 15%). Tacrolimus seems to be a mo
re potent immunosuppressant after lung transplantation than CyA; on the oth
er hand, diabetes and nephrotoxicity were diagnosed more frequently using t
acrolimus. Although our results are very promising, further follow-up on th
e incidence of obliterative bronchiolitis is warranted.