Immediate- vs extended-release tacrolimus in lung transplant recipients: The REVOLUTION trial

Results from the open-label, randomized controlled REVOLUTION trial (NCT05001074), comparing immediate-release (n = 32) vs once-daily extended-release (n = 29) tacrolimus in de novo lung transplant recipients were presented by Juul Daamen at the 31st International Congress of The Transplantation Society (TTS), September 20–23, 2026, Sydney, AU. The primary endpoint was the absolute change in estimated glomerular filtration rate (eGFR) from baseline to Month 24. 

Key data: The median change in eGFR at Month 24 did not differ between the immediate- vs extended-release tacrolimus groups (p = 0.95). Rates of acute rejection (p = 1.00), chronic rejection (p = 0.61), post-transplant diabetes (p = 0.16), and malignancies (p = 0.23) were comparable between formulations. Quality of life was similar with immediate- vs extended-release tacrolimus, with no significant differences in physical component summary (PCS) scores (32.3 vs 33.6; p = 0.57) or mental component summary (MCS) scores (51.0 vs 41.3; p = 0.19).

Key learning: In this study, immediate- and extended-release tacrolimus were associated with comparable clinical outcomes and quality of life measures at 24 months in de novo lung transplant recipients.