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Fall in human herpes- virus-6 seropositivity with age[Letter]. Lancet 1988; 13: 396. Received 28 September 1999. Accepted 8 March 2000. 0041-1337/00/6912-2573/0 TRANSPLANTATION Vol. 69, 2573–2580, No. 12, June 27, 2000 Copyright © 2000 by Lippincott Williams & Wilkins, Inc. Printed in U.S.A. LONG-TERM RESULTS AFTER CONVERSION FROM CYCLOSPORINE TO TACROLIMUS IN PEDIATRIC LIVER TRANSPLANTATION FOR ACUTE AND CHRONIC REJECTION JORGE REYES, 1 ASHOK JAIN,GEORGE MAZARIEGOS,RANDEEP KASHYAP,MIKE GREEN, KATHY IURLANO, AND JOHN FUNG Thomas E. Starzl Transplantation Institute,University of Pittsburgh Medical Center and Children Hospital, Pittsburgh, PA 15213 Tacrolimus is beneficial in liver transplantation for reversing steroid-resistant acute rejection, and for controlling the process of chronic rejection in allo- graft recipients receiving Cyclosporine- (CyA) based regimens. Very little is known about the long-term efficacy of tacrolimus in pediatric transplantation af- ter conversion from CyA. Our study examines the long- term outcome after conversion to tacrolimus for acute or chronic rejection in pediatric liver transplant (LTx) recipients. Method. Seventy-three children (age < 18 years) re- ceiving their primary LTx under CyA between August 1989 and April 1996 were converted to tacrolimus for ongoing acute rejection (n22, group I) or chronic rejection (n51, group II). Mean age at the time of conversion was 10.25.5 years with a mean interval from LTx to conversion of 3.52.9 (range 0.5–10.1 years). There were 33 boys and 40 girls. All patients were followed until June 1999. Mean follow-up was 97.317.4 months (range 62.4 –118.9 months). Results. Overall 5-year actual patient survival was 78.1% and 8-year actuarial survival was 74.6%. Pa- tients converted to tacrolimus therapy to resolve acute rejection (group I) experience significantly bet- ter patient and graft survival at 5 and 8 years than those converted to resolve chronic rejection (group 1 Address correspondence to: Jorge Reyes, Thomas E. Starzl Transplantation Institute, 3601 Fifth Avenue, 4c Falk Clinic, Pitts- burgh, PA 15213. REYES ET AL. June 27, 2000 2573