[The rescue effect of FK506 in refractory rejection after cardiac transplantation].

The patient with dilated cardiomyopathy (NYHA class 4) under went cardiac transplantation at University of California, Los Angeles. Severe cardiac rejection was revealed one month after the transplantation. Steroid therapy was not effective, the rejection was resolved with OKT3 therapy and Anti-thymocyte globulin. Moreover, severe rejection was seen five months later. Steroid therapy was not effective. Cyclosporine administration was substituted for FK506 (0.02 mg/kg/day). After the induction of FK506, the number of CD8 positive cells decreased and cardiac rejection was successfully resolved. As side effect of FK506, bradycardia with heart rate of 50/min for 4 minutes appeared. However, it was well-controlled when the trough level of FK506 was reduced to less than 8 ng/ml.