Survival Associated With Sirolimus Plus Tacrolimus Maintenance Without Induction Therapy Compared With Standard Immunosuppression After Lung Transplant

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Abstract
Lung transplant is life prolonging for patients with end-stage lung disease, but high mortality limits median posttransplant survival to less than 6 years. Patients receive lifelong immunosuppressive regimens to prevent eventual lung function loss owing to chronic lung allograft dysfunction resulting from chronic rejection, which usually manifests as bronchiolitis obliterans syndrome or restrictive allograft syndrome.1,2 Unfortunately, immunosuppressive regimens are not completely effective in preventing chronic rejection, and many patients die of immunosuppression-related consequences, including infections and malignant disease. No immunosuppressive drug currently has US Food and Drug Administration approval for patients who have received a lung transplant, so all drugs are used off-label.

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