Experience of using FK 506 as a rescue therapy for refractory hepatic allograft rejection

FK 506 (Tacrolimus) is a new molecular entity discovered in 1984 and has been documented as a potent immunosuppressant both in vitro and in vivo. In clinical studies, FK 506 has been used as an effective agent in the prophylaxis of allograft rejection and rescue of patients with refractory rejection after human liver, kidney, or heart transplantation. In Taiwan, we started a collaborative study using FK 506 to rescue steroid refractory rejection in 1995. We hereby report our experience of applying FK 506 (Tacrolimus) as a rescue therapy on three patients suffering from refractory hepatic allograft rejection. No graft loss or patient death occurred in our series. Two patients experienced rapid reversal, and one patient a delayed reversal. We also observed steroid-withdrawal effect in one patient after conversion of treatment to FK 506. No prominent side effects were noted in the use of FK 506 except a gastrointestinal disturbance (severe diarrhea) in one patient. In conclusion, FK 506 has proved to be effective as a rescue therapy in refractory hepatic allograft rejection. We may apply this new immunosuppressive drug as primary antirejection therapy after a liver transplantation in Taiwan in the future.