Lung Transplantation Clinical Trial
Official title:
Prospective Randomized Trial to Compare a Twice Daily to a Once Daily Administration of the Tacrolimus in Lung Transplanted Patients
This study is a prospective randomized trial to compare twice daily to once daily administration of the basic immunosuppressive regimen in lung transplanted patients.
Prevalence data of non-compliance in solid organ transplantations fluctuate is reported in up
to 39% of transplant recipients (z. B. for lung transplantations 13 - 22%; Kugler et al.).
Non-compliance with immunosuppressive therapy is associated with an increased risk of
late-acute rejections and the development of chronic transplant dysfunction. Chronic
transplant dysfunction (bronchiolitis obliterans- syndrome-BOS) is the second most causing
for organ failure after the first year following lung transplantation and often leads to
re-transplantation or death. Preventative procedures for improving the compliance are
simplification of the dose of the immunosuppressants (a once daily dose instead of a twice
daily dose), the prescription of an immunosuppressants with less side-effects and to raise
the patient´s awareness for having the greatest responsibility for the efficacy of his
therapy. Prospective studies and metaanalysis revealed that the probability for a good
compliance can be more than doubled at once daily administration in comparison to twice daily
and the best predictor for a good compliance is an easy therapy. For this reason we want to
investigate the extent of profit for our lung transplant patients receiving once daily basis
immunosuppression in comparison to those who receive twice daily dose.
Hypothesis: Patients of the once daily administration group of the immunosuppressive
medication will have a better compliance compared to the twice daily group (as measured by
the endpoints variability and medication abstraction from the electronic devices)
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