Tacrolimus – transplant backbone — RACP Paediatrics MCQ

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ModerateCardiologyTacrolimus – transplant backboneRACP Paediatrics

The same child requires ongoing immunosuppression. What is the backbone calcineurin inhibitor used in most paediatric cardiac transplant protocols?

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Correct answer: C — Tacrolimus (calcineurin inhibitor)

Tacrolimus is the backbone calcineurin inhibitor in most modern paediatric cardiac transplant protocols (replacing ciclosporin). Standard triple therapy is tacrolimus + mycophenolate mofetil + prednisolone. Tacrolimus requires therapeutic drug monitoring (trough levels). Key side effects include nephrotoxicity, diabetes, and increased infection risk.

Reference: RCH Melbourne – 2023 – Transplant CPG; RACP Paediatric Curriculum – Cardiology