Organ transplantation has now been technically feasible for several decades. However, it was only when 6-Mercaptopurin and its derivate azathioprine, were discovered that clinical transplantation became possible. During the 1960s and 1970s, a combination of steroids with azathioprine became the standard regimen for immunosuppression - until the discovery of ciclosporin, which allowed improvements both in patient survival and in transplant survival following transplantation surgery. During the 1980s and 1990s - in spite of an intensive search for new immunosuppressive drugs and the development of a range of new substances such as mizoribine, deoxyspergualin, mycophenolate mofetil, rapamycin, brequinar, and leflunomide - ciclosporin then became the gold standard in immunosuppression.
It was inly in 1989, at the ESOT conference in Barcelona, that the first report of a new substance claimed to be at least as effective as ciclosporin was presented. In the meantime, many experimental and clinical studies have confirmed the remarkable characteristics of tacrolimus. Large international studies habe established the effectiveness and safety of the substance as a basic immunosuppressive drug for preventing rejections after liver and kidney transplantation. Tacrolimus has also been used successfully in numerous single-center studies in the treatment of allograft rejections. In addition, promising results in heart and pancreas transplantation have also been achieved in initial studies.
The symposium "Tacrolimus in Organ Transplantation: Prevention and Treatment of Allograft Rejections" held on 26 July 1997 under the chairmanship of Prof. Dr. Thiel and PD Dr. Mosimann in Pont-la-Ville, Switzerland, provided an overview of the current state of knowledge concerning tacrolimus. The topics discussed ranged from the discovery of the substance, specialized aspects of pharmacokinetics and blood level measurements, to clinical results in liver, kidney and heart transplantation. Initial experiences with tacrolimus in Switzerland were also described.