Successful conversion from twice-daily to once-daily tacrolimus in liver transplantation: observational multicenter study.

Abstract

BACKGROUND:

Compliance with immunosuppressive therapy in liver transplant patients is critical to prevent acute organ rejection and/or late graft loss. Strategies to simplify the therapeutic regimen may improve adherence.

AIM:

To evaluate the safety and efficacy of conversion from a twice-daily to once-daily tacrolimus formulation in adult liver transplant patients.

PATIENTS AND METHODS:

This prospective observational multicenter study included 187 liver transplant patients with at least 10 months post-transplant follow-up, no rejection episodes in the last three months, and creatinine levels <2 mg/dL. Conversion from a twice-daily to a once-daily formulation was based on a 1:1 proportion.

RESULTS:

Median age was 61 yr (range: 28-80 yr); 64% were men and 36% women. The main indications for liver transplant were alcoholic cirrhosis in 30%. Median conversion time was 55 months (range: 10-215 months). Serum tacrolimus levels decreased at one month after conversion (pre-conversion levels = 5.4 ± 3.0 ng/mL vs. post-conversion levels = 4.4 ± 2.4 ng/mL, p = 0.013); however, these values normalized at six months post-conversion with no changes in liver function and rejection episodes were observed only in two patients.

CONCLUSION:

Conversion from a twice-daily to a once-daily tacrolimus formulation is a safe, effective strategy in the management of stable liver transplant patients.

• Authors: Cristina Dopazo, Roberto Rodriguez, Laura Llado, David Calatayud, Lluis Castells, Emilio Ramos, Victor Molina, Raquel García, Joan Fabregat, Ramon Charco
• Journal: Clinical transplantation (Clin Transplant) 2012 Jan-Feb Vol. 26 Issue 1 Pg. E32-7 ISSN: 1399-0012 [Electronic] Denmark
• PMID: 21958123 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2011 John Wiley & Sons A/S.

Chemical References

• Immunosuppressive Agents
• Tacrolimus

Topics

• Adult
• Aged
• Aged, 80 and over
• Drug Administration Schedule
• Female
• Follow-Up Studies
• Humans
• Immunosuppressive Agents (administration & dosage)
• Liver Transplantation
• Male
• Middle Aged
• Patient Compliance
• Prognosis
• Prospective Studies
• Risk Factors
• Tacrolimus (administration & dosage)