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Tacrolimus in Heart Transplant Recipients

An Overview

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Abstract

The development of cyclosporine was pivotal in allowing cardiac transplantation to become an accepted treatment for patients with end-stage heart disease. More recently, tacrolimus has become available as a useful alternative to cyclosporine, and has been successfully combined with either azathioprine or the newer anti-proliferative agents, mycophenolate mofetil or sirolimus. Numerous randomized clinical trials have demonstrated that tacrolimus is comparable to cyclosporine in terms of overall patient survival and at least equally effective in preventing acute rejection. In addition, tacrolimus has been particularly effective as a rescue treatment in cases where recurrent rejection has occurred with cyclosporine.

The adverse effects of tacrolimus differ from those of cyclosporine, and the drug particularly shows an improved profile with respect to hypertension, dyslipidemia, and long-term renal function. These data have recently led to the regulatory approval of tacrolimus for primary immunosuppression in patients undergoing cardiac transplantation in the US.

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Acknowledgements

Dr Patel has received research grants for clinical trials from Novartis, Roche, Medtronic and Astellas Pharma. Dr Kobashigawa has received research grants for clinical trials from Novartis, Roche, XDx and Astellas Pharma, and has received honoraria from and served on advisory boards for Novartis, Roche and Astellas Pharma.

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. Division of Cardiology, David Geffen School of Medicine at UCLA, 100 UCLA Medical Plaza #630, Los Angeles, CA, 90095, USA

    Jignesh K. Patel &  Jon A. Kobashigawa

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  1. Jignesh K. Patel
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  2. Jon A. Kobashigawa
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Correspondence to Jon A. Kobashigawa.

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Patel, J.K., Kobashigawa, J.A. Tacrolimus in Heart Transplant Recipients. BioDrugs 21, 139–143 (2007). https://doi.org/10.2165/00063030-200721030-00001

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