Children suffering from organ rejection or complications of their anti-rejection drugs can be successfully converted to tacrolimus with long-term benefits, according to a study of 85 liver transplant patients who were switched from cyclosporine to tacrolimus between 1989 and 1994. Children with acute rejection had better outcomes than those with chronic rejection, Jorge Reyes, M.D., associate professor of surgery at the Thomas E. Starzl Transplantation Institute and director of pediatric transplantation at Children's Hospital of Pittsburgh, will report Sunday, Nov. 8. Patient and graft survival six years after being converted to tacrolimus was 91 and 87 percent, respectively, for those with acute rejection. But for children with chronic rejection, patient survival was 67 percent, and graft survival was 57 percent at six years. The advantages of tacrolimus (formerly known as FK506 and now marketed as Prograf) were also evident by virtue of the fact that 84 percent of the patients could be weaned off steroids, thus eliminating many of the side effects specific to children, such as stunted growth and puffy cheeks that give the appearance of a moon face. Fifty-eight percent were also able to be taken off antihypertensive medications.
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The scientific meeting will also include a day-long series of debates on "Clinical and Administrative Controversies in Liver and Pancreas Transplantation" scheduled for Saturday, Nov. 7. The UPMC, which has strongly advocated for changes in the organ allocation system, will participate in two of three debates on this subject.