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Tacrolimus immunosuppression in high-risk corneal grafts

2006; BMJ; Volume: 91; Issue: 1 Linguagem: Inglês

10.1136/bjo.2006.097428

1468-2079

Annie Joseph, D. Raj, Vijay Shanmuganathan, R J Powell, Harminder S. Dua,

Ocular Infections and Treatments

Background: Unlike the immune privilege enjoyed by low-risk corneal grafts, high-risk corneal grafts experience rejection rates comparable to liver and kidney transplants. Systemic immunosuppression reduces the risk of rejection in high-risk corneal grafts. Methods: Systemic tacrolimus, a specific T cell inhibitor, was used at a mean daily dose of 2.5 mg to immunosuppress 43 patients undergoing high-risk corneal transplantation. Immunosuppression was continued for a period of 18–24 months after the high-risk corneal graft. Results: During a mean follow-up period of 33.7 months, clarity of the graft was maintained in 65% of patients. Eight patients experienced rejection episodes while on tacrolimus, and this led to graft failure in five patients. Conclusion: Tacrolimus is relatively safe and effective in reducing rejection and prolonging graft survival in patients with high-risk keratoplasty compared with other series where similar immunosuppression was not used.