Once-per-day tacrolimus to reduce chronic lung transplant rejection

The incidence of chronic lung allograft dysfunction (CLAD; the official term for chronic rejection) has remained unchanged for decades, and its effects are devastating: patients with CLAD report significant dyspnoea and have a decreased quality of life, and CLAD is the leading cause of death for patients who survive at least 1 year post transplantation. 1 Verleden GM Glanville AR Lease ED et al. Chronic lung allograft dysfunction: definition, diagnostic criteria, and approaches to treatment—a consensus report from the Pulmonary Council of the ISHLT. J Heart Lung Transplant. 2019; 38: 493-503 Summary Full Text Full Text PDF PubMed Scopus (434) Google Scholar , 2 Singer JP Singer LG Quality of life in lung transplantation. Semin Respir Crit Care Med. 2013; 34: 421-430 Crossref PubMed Scopus (58) Google Scholar Despite recognition of CLAD as the primary problem facing the field of lung transplantation, effective strategies to prevent or treat CLAD have not been definitively established. Effect of once-per-day tacrolimus versus twice-per-day ciclosporin on 3-year incidence of chronic lung allograft dysfunction after lung transplantation in Scandinavia (ScanCLAD): a multicentre randomised controlled trialImmunosuppression based on use of tacrolimus once per day significantly reduced the incidence of CLAD compared with use of ciclosporin twice per day. These findings support the use of tacrolimus as the first choice of calcineurin inhibitor after lung transplantation. Full-Text PDF