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Trough Level and Tacrolimus Variability of Early Converted Once-Daily Tacrolimus: 1-Year Follow-up Study.

Abstract：

INTRODUCTION:Long-term transplant outcomes are considered a crucial point for kidney transplantation. Follow-up studies in patients receiving early conversion to once-daily tacrolimus (TAC-OD) are still limited. We aimed to investigate tacrolimus trough level (Cmin), intrapatient variability of tacrolimus dose-normalized Cmin (TAC-Cmin/D), along with other outcomes between twice-daily tacrolimus (TAC-BID) and early converted TAC-OD. MATERIAL AND METHODS:This study was a single center, retrospective, cohort study. All new kidney transplant patients who received tacrolimus and presented an estimated glomerular filtration rate of more than 45 mL/min/1.73 m2 on the day of hospital discharge were included. Studied patients were divided into the standard TAC-BID and patients who were converted from TAC-BID to TAC-OD on the day of hospital discharge. We followed patients for 1 year after transplantation. RESULTS:At the first follow-up visit, Cmin of TAC-OD was significantly lower than that of TAC-BID. However, Cmin and estimated glomerular filtration rate were comparable between TAC-BID and TAC-OD throughout 1-year follow-up. TAC-OD also provided a lower intrapatient variability of TAC-Cmin/D compared with TAC-BID when observed after 6 months post transplantation (17.40% and 23.27% for TAC-OD and TAC-BID, respectively; P = .13). The renal function, as well as other adverse outcomes, was similar between 2 formulations. DISCUSSION:TAC-OD provided a similar Cmin with comparable renal function compared with TAC-BID during 1-year follow-up. In addition, TAC-OD is likely to have a benefit of a lower intrapatient variability of tacrolimus. CONCLUSION:Early conversion from TAC-BID to TAC-OD with 1:1 ratio can be used with close long-term monitoring.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Sukkha S,Suansanae T,Iamrahong P,Wiwattanathum P

doi

10.1016/j.transproceed.2019.12.039

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

775-779

issue

3

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(19)30855-3

journal_volume

52

pub_type

杂志文章

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