Renal function after conversion from cyclosporine to FK 506 in liver transplant patients.

Abstract

FK 506, a macrolide antibiotic, is a powerful immunosuppressant which is approximately 100 times more potent than cyclosporine (CyA). The first clinical experience with this agent was attained in patients with refractory hepatic rejection and complications of CyA therapy.1,2 Initial experience suggested that FK 506 was surprisingly effective in reversing rejection in these patients. In the first patients, the combined nephrotoxicity of FK 506 and CyA was apparent. Serum creatinine (SCr) regularly increased and, at times, dramatically.3 This was termed the “crossover nephrotoxicity” of FK 506 and CyA. FK 506 has now been used for approximately 2 years at the University of Pittsburgh. We will update our experience with the changes in renal function after conversion from CyA to FK 506.