Long-term Follow-up of Stable Kidney Transplant Recipients After Conversion From Tacrolimus Twice Daily Immediate Release to Tacrolimus Once-daily Prolonged Release: A Large Single-Center Experience

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• 作者：J. Slatinska ; ^jnsl@ikem.cz ; T. Rohal ; M. Wohlfahrtova ; O. Viklicky
• 刊名：Transplantation Proceedings
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：45
• 期：4
• 页码：1491-1496
• 全文大小：314 K

文摘

Background

Adult kidney transplant recipients maintained on tacrolimus twice-daily (Tac BD) were given the opportunity to convert to tacrolimus once daily (Tac QD). Conversion was based upon a 1:1 mg:mg total daily dose ratio.

Methods

Between November 2007 and September 2010, 589 patients were converted at a mean post-transplant period of 4.6 years. We retrospectively reviewed routine clinical records to assess the safety of conversion to Tac QD for up to 12 months post-conversion.

Results

Tac QD mean dose barely changed from preconversion values. Mean exposure (tacrolimus trough blood level [C_min]) remained within the target window but was reduced by 12 % (P = NS) with a trend toward less interpatient variability. Renal function at 12 months remained stable within 2.5 % of the preconversion mean value. There were 14 (2.4 % ) cases of biopsy-proven acute rejection: 6 (1.0 % ) borderline and 8 (1.4 % ) Banff grade ¡Ý IA. Actuarial first year post-conversion graft survival was 96.3 % and patient survival 99.0 % . Twenty-eight patients (4.8 % ) discontinued Tac QD and were switched to sirolimus: 19 for malignancy, 6 for thrombotic microangiopathy, and 3 with severe vascular changes; 3 patients were reconverted to Tac BD.

Conclusions

Conversion from Tac BD to Tac QD in renal recipients was accompanied by stable renal function, a low risk of acute rejection, and less interpatient variability in drug exposure.