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PMID: 1693970 Published · ppublish English Journal Article Research Support, U.S. Gov't, Non-P.H.S. Research Support, U.S. Gov't, P.H.S.

Kidney transplantation under FK 506.

JAMA ·Vol. 264 ·No. 1 ·1990-07-04 ·Pages 63-7

Starzl TE, Fung J, Jordan M, Shapiro R, Tzakis A, McCauley J, Johnston J, Iwaki Y, Jain A, Alessiani M

Abstract

The experimental immunosuppressive drug FK 506 was given to 36 renal transplant recipients, many of whom were highly sensitized. Ten were undergoing kidney retransplantation, 10 also underwent liver transplantation at an earlier time (6 patients) or concomitantly (4 patients), and 2 patients received a third organ (heart or pancreas) in addition to a liver and kidney. With follow-ups of 4 to 13 months, all but 2 of the 36 patients are alive, 29 (81%) are dialysis free, and most have good renal function. Twenty of the 29 dialysis-free patients are receiving no or low-dose (2.5 to 5.0 mg/d) prednisone therapy. Only one kidney was lost to cellular rejection. However, patients who had antidonor cytotoxic antibodies in current or historical serum samples had a high rate (3 of 9) of irreversible humoral rejection. A low incidence of posttransplant hypertension was noteworthy. Hirsutism and gingival hyperplasia were not observed. Serum cholesterol levels in patients who took FK 506 were unexpectedly low, and the effect on the level of uric acid was minimal. The side effects of FK 506 therapy include nephrotoxicity, neurotoxicity, and potential induction of a diabetic state. These are similar to the side effects of cyclosporine use, but probably less severe. The seeming safety, efficacy, and relative freedom from side effects of FK 506 encourage further trials in kidney transplantation.

MeSH Terms
Adult Anti-Bacterial Agents/adverse effects,therapeutic use Child Female Follow-Up Studies Graft Rejection Humans Immunosuppressive Agents/adverse effects,therapeutic use Infections/etiology Kidney Failure, Chronic/mortality,surgery Kidney Transplantation/adverse effects,mortality Male Middle Aged Tacrolimus Tissue Donors
Chemicals
Anti-Bacterial Agents Immunosuppressive Agents Tacrolimus
Authors & Affiliations
10 authors, click to expand affiliations / ORCID
Starzl T E
Department of Surgery, University Health Center of Pittsburgh, PA 15213.
Fung J
Jordan M
Shapiro R
Tzakis A
McCauley J
Johnston J
Iwaki Y
Jain A
Alessiani M
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37 references, click to expand
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Article Info
Journal
JAMA
Abbr.
JAMA
ISSN
0098-7484
Published
1990-07-04
Pages
63-7
Language
English
Region
United States
NLM ID
7501160
PMCID
PMC2979318
Subset
IM
Grants
NIDDK NIH HHS · R01 DK029961-19 · United States
NIDDK NIH HHS · DK 29961 · United States
External Links
PubMed source PMC Full Text View journal details
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