Conversion from cyclosporin to tacrolimus in paediatric liver transplant recipients

G. V. Mazariegos, A. A. Salzedas, Ashokkumar Jain, J. Reyes

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Substitution of cyclosporin with tacrolimus should be considered for paediatric liver transplant recipients with cyclosporin-associated complications such as hypertension, gum hyperplasia, hirsutism, gynaecomastia and growth retardation, as well as recurrent or refractory acute rejection, chronic duct injury or chronic rejection. Continued experience with well tolerated drug administration and careful monitoring during drug substitution has limited drug toxicity associated with tacrolimus to a level comparable to or less than that associated with cyclosporin. Successful outcome with long term graft salvage has been reported in up to 80% of patients converted to tacrolimus because of acute rejection and 50% of patients converted because of chronic rejection. Nearly all children converted because of cyclosporin-related complications have a successful outcome. Additional benefits of conversion to tacrolimus include improvement in growth and resolution of hypertension, hirsutism and cushingoid facies. Complete corticosteroid withdrawal is possible in up to 78% of children post-conversion. Long term outcome in these patients may be optimised by conversion to tacrolimus at an early stage of acute or chronic transplant rejection in order to minimise the cumulative amount of immunosuppression. Avoidance of cyclosporin-related toxicity and minimisation of corticosteroid therapy may further improve patient compliance to drug therapy.

Original languageEnglish (US)
Pages (from-to)661-672
Number of pages12
JournalPaediatric Drugs
Volume3
Issue number9
DOIs
StatePublished - Jan 1 2001

Fingerprint

Tacrolimus
Cyclosporine
Pediatrics
Liver
Hirsutism
Adrenal Cortex Hormones
Drug Substitution
Hypertension
Graft Rejection
Gingiva
Patient Compliance
Growth
Drug-Related Side Effects and Adverse Reactions
Immunosuppression
Hyperplasia
Transplant Recipients
Transplants
Drug Therapy
Rejection (Psychology)
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)

Cite this

Mazariegos, G. V. ; Salzedas, A. A. ; Jain, Ashokkumar ; Reyes, J. / Conversion from cyclosporin to tacrolimus in paediatric liver transplant recipients. In: Paediatric Drugs. 2001 ; Vol. 3, No. 9. pp. 661-672.
@article{14a4b37835b442439eb5ec2e03b9b19d,
title = "Conversion from cyclosporin to tacrolimus in paediatric liver transplant recipients",
abstract = "Substitution of cyclosporin with tacrolimus should be considered for paediatric liver transplant recipients with cyclosporin-associated complications such as hypertension, gum hyperplasia, hirsutism, gynaecomastia and growth retardation, as well as recurrent or refractory acute rejection, chronic duct injury or chronic rejection. Continued experience with well tolerated drug administration and careful monitoring during drug substitution has limited drug toxicity associated with tacrolimus to a level comparable to or less than that associated with cyclosporin. Successful outcome with long term graft salvage has been reported in up to 80{\%} of patients converted to tacrolimus because of acute rejection and 50{\%} of patients converted because of chronic rejection. Nearly all children converted because of cyclosporin-related complications have a successful outcome. Additional benefits of conversion to tacrolimus include improvement in growth and resolution of hypertension, hirsutism and cushingoid facies. Complete corticosteroid withdrawal is possible in up to 78{\%} of children post-conversion. Long term outcome in these patients may be optimised by conversion to tacrolimus at an early stage of acute or chronic transplant rejection in order to minimise the cumulative amount of immunosuppression. Avoidance of cyclosporin-related toxicity and minimisation of corticosteroid therapy may further improve patient compliance to drug therapy.",
author = "Mazariegos, {G. V.} and Salzedas, {A. A.} and Ashokkumar Jain and J. Reyes",
year = "2001",
month = "1",
day = "1",
doi = "10.2165/00128072-200103090-00004",
language = "English (US)",
volume = "3",
pages = "661--672",
journal = "Paediatric Drugs",
issn = "1174-5878",
publisher = "Adis International Ltd",
number = "9",

}

Conversion from cyclosporin to tacrolimus in paediatric liver transplant recipients. / Mazariegos, G. V.; Salzedas, A. A.; Jain, Ashokkumar; Reyes, J.

In: Paediatric Drugs, Vol. 3, No. 9, 01.01.2001, p. 661-672.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Conversion from cyclosporin to tacrolimus in paediatric liver transplant recipients

AU - Mazariegos, G. V.

AU - Salzedas, A. A.

AU - Jain, Ashokkumar

AU - Reyes, J.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Substitution of cyclosporin with tacrolimus should be considered for paediatric liver transplant recipients with cyclosporin-associated complications such as hypertension, gum hyperplasia, hirsutism, gynaecomastia and growth retardation, as well as recurrent or refractory acute rejection, chronic duct injury or chronic rejection. Continued experience with well tolerated drug administration and careful monitoring during drug substitution has limited drug toxicity associated with tacrolimus to a level comparable to or less than that associated with cyclosporin. Successful outcome with long term graft salvage has been reported in up to 80% of patients converted to tacrolimus because of acute rejection and 50% of patients converted because of chronic rejection. Nearly all children converted because of cyclosporin-related complications have a successful outcome. Additional benefits of conversion to tacrolimus include improvement in growth and resolution of hypertension, hirsutism and cushingoid facies. Complete corticosteroid withdrawal is possible in up to 78% of children post-conversion. Long term outcome in these patients may be optimised by conversion to tacrolimus at an early stage of acute or chronic transplant rejection in order to minimise the cumulative amount of immunosuppression. Avoidance of cyclosporin-related toxicity and minimisation of corticosteroid therapy may further improve patient compliance to drug therapy.

AB - Substitution of cyclosporin with tacrolimus should be considered for paediatric liver transplant recipients with cyclosporin-associated complications such as hypertension, gum hyperplasia, hirsutism, gynaecomastia and growth retardation, as well as recurrent or refractory acute rejection, chronic duct injury or chronic rejection. Continued experience with well tolerated drug administration and careful monitoring during drug substitution has limited drug toxicity associated with tacrolimus to a level comparable to or less than that associated with cyclosporin. Successful outcome with long term graft salvage has been reported in up to 80% of patients converted to tacrolimus because of acute rejection and 50% of patients converted because of chronic rejection. Nearly all children converted because of cyclosporin-related complications have a successful outcome. Additional benefits of conversion to tacrolimus include improvement in growth and resolution of hypertension, hirsutism and cushingoid facies. Complete corticosteroid withdrawal is possible in up to 78% of children post-conversion. Long term outcome in these patients may be optimised by conversion to tacrolimus at an early stage of acute or chronic transplant rejection in order to minimise the cumulative amount of immunosuppression. Avoidance of cyclosporin-related toxicity and minimisation of corticosteroid therapy may further improve patient compliance to drug therapy.

UR - http://www.scopus.com/inward/record.url?scp=0034771807&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034771807&partnerID=8YFLogxK

U2 - 10.2165/00128072-200103090-00004

DO - 10.2165/00128072-200103090-00004

M3 - Review article

C2 - 11688597

AN - SCOPUS:0034771807

VL - 3

SP - 661

EP - 672

JO - Paediatric Drugs

JF - Paediatric Drugs

SN - 1174-5878

IS - 9

ER -