A prospective, randomized trial of single-drug versus dual-drug immunosuppression in heart transplantation: the tacrolimus in combination, tacrolimus alone compared (TICTAC) trial.

Background: Cardiac transplantation, a procedure nearly abandoned in the 1970s, has evolved into the standard of care for appropriate patients with end-stage heart failure. Much of this success has been due to improvements in immunosuppression, including the introduction of a triple-drug regimen. Retrospective reports suggested that single-drug immunosuppression with tacrolimus was feasible.

Simple method to eliminate interference between ventricular assist devices and cardiac rhythm devices.

Background: Report on a simple solution to allow programming of defibrillators in the presence of a Heartmate II (Thoratec Corporation, Pleasanton, CA, USA) ventricular assist device. Ventricular assist devices have become increasingly utilized for patients waiting for heart transplantation as well as those who will be maintained on a permanent support. The Heartmate II, which was recently given Food and Drug Administration approval as a bridge-to-transplant device, has a particular anomaly that complicates patient management.

Randomized trial of tacrolimus monotherapy: tacrolimus in combination, tacrolimus alone compared (the TICTAC trial).

Background: Prior retrospective studies have suggested that tacrolimus monotherapy is an option associated with excellent outcomes and reduced toxicities.

Method: We conducted a prospective, randomized, 2-center study of tacrolimus combination therapy vs monotherapy. From April 16, 2004, to September 15, 2005, 58 adult heart transplant patients were studied.