Conversion from Twice-Daily to Once-Daily Tacrolimus Administration in Liver Transplant Patient: Results of Long Term Follow-Up

Giannelli, V.; Rossi, Massimo; Giusto, M.; Lucidi, C.; Lattanzi, Barbara; Ruffa, A.; Corradini, Stefano Ginanni; Mennini, Gianluca; Melandro, Fabio; Lai, Quirino; Berloco, P.; Merli, Manuela

doi:10.1097/00007890-201211271-01468

Cited by 7 publications

(6 citation statements)

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“…Finally, improved adherence to treatment with a simplified once‐daily regimen has been described as a key factor in patient and graft survival . Moreover, improvement in adherence has been established both in liver and renal transplant recipients after conversion from bid tacrolimus to T‐qd . Although we did not specifically study treatment adherence, we may indirectly assume that our patients’ compliance was good because the rates of rejection, immunological complications, and death were low in our study.…”

Section: Discussionmentioning

confidence: 81%

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Favorable longterm outcomes of liver transplant recipients treated de novo with once‐daily tacrolimus: Results of a single‐center cohort

et al. 2016

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The once-daily prolonged-release formulation of tacrolimus has been recently related with significant graft and patient mid-term survival advantages; however, practical information on the de novo administration after liver transplantation and longterm outcomes is currently lacking. This study is a 5-year retrospective analysis of a single-center cohort of liver transplant recipients treated de novo with once-daily tacrolimus (April 2008/August 2011). The study cohort consisted of 160 patients, including 23 with pretransplant renal dysfunction, with a median follow-up of 57.6 months (interquartile range, 46.6-69.0). Tacrolimus target trough levels were 5-10 ng/mL during the first 3 months after transplant, reducing progressively to <7 ng/mL after the first posttransplant year. Once-daily tacrolimus was withdrawn in 35 (21.8%) patients during follow-up, mostly due to renal dysfunction and/or metabolic syndrome. The biopsy-proven acute rejection rate was 12.5% with no cases of steroid-resistant rejection. The cumulative incidence of de novo diabetes, hypertension, and dyslipidemia were 16.9%, 31.2%, and 6.5%, respectively. Hepatocellular carcinoma recurrence rate was 2.8%. Renal function remained stable after the sixth month after transplant with a mean estimated glomerular filtration rate of 77.7 ± 19.6 mL/minute/1.73 m(2) at 5 years. None of our patients developed chronic kidney disease stage 4 or 5. Patient survival at 1, 3, and 5 years was 96.3%, 91.9%, and 88.3%, respectively. Overall survival of patients with Model for End-Stage Liver Disease (MELD) score > 25 points was not significantly different. In conclusion, our study suggests that immunosuppression based on de novo once-daily tacrolimus is feasible in routine clinical practice, showing favorable outcomes and outstanding longterm survival even in patients with high MELD scores. Liver Transplantation 22 1391-1400 2016 AASLD.

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Section: Discussionmentioning

confidence: 81%

“…Several LT studies have addressed short‐ and medium‐term outcomes after conversion to T‐qd . In these studies, clinical outcomes have been similar to bid tacrolimus after follow‐up periods of between 6 and 24 months.…”

mentioning

confidence: 99%

Favorable longterm outcomes of liver transplant recipients treated de novo with once‐daily tacrolimus: Results of a single‐center cohort

et al. 2016

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“…In the majority of the 17 studies, tacrolimus levels were reduced after 1:1 conversion, but tended to normalize back to preconversion levels after physician-initiated dose increases in a subset of patients. 69,[80][81][82][83][84][85][86] However, this finding was not universal across all studies and, even in studies showing an initial mean decrease in trough levels, a subset of patients had higher levels after conversion. 69,87 A detailed open-label multicenter prospective study investigated the pharmacokinetic effect of crossover using a four-period crossover design in which patients received TAC BID and TAC QD in alternating 14 day blocks.…”

Section: Conversion To Tac Qd In Stable Adult Liver Transplant Recipimentioning

confidence: 97%

“…39,69,[80][81][82][83][84][85][86][87][88][89][90][91][92][93][94] The majority of the studies were observational crossover studies examining pharmacokinetic profiles and efficacy in patients before and after conversion. We did not identify randomized or blinded controlled trials.…”

Section: Conversion To Tac Qd In Stable Adult Liver Transplant Recipimentioning

confidence: 99%

“…In one study, renal function was significantly improved after conversion, with the MDRD eGFR rising from 71 to 82 mL/min (P=0.001), but there was no control arm. 86 A change back from TAC QD to TAC BID was infrequent; a 24 month retrospective study of 394 patients found that only 16 patients switched back to TAC BID for various reasons, the commonest being tremor (n=3). 85 Taken together, these data suggest that conversion to TAC QD is safe and efficacious.…”

Section: Conversion To Tac Qd In Stable Adult Liver Transplant Recipimentioning

confidence: 99%

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Prevention of organ rejection in renal and liver transplantation with extended release tacrolimus

Reschen¹,

O’Callaghan²

2014

TRRM

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Tacrolimus is the key immunosuppressant used to prevent allograft rejection in kidney and liver transplant recipients. Despite the efficacy of tacrolimus and adjunctive immunosuppressants, a substantial number of patients experience episodes of acute rejection and late graft loss. Nonadherence is an etiological factor in both acute rejection and graft loss. In 2007, a prolonged release version of tacrolimus became available that allows once daily administration, thus halving the pill burden compared to the standard twice-daily tacrolimus. An increasing number of studies in de novo transplantation and in treatment conversion have evaluated the pharmacokinetic profile, efficacy, and safety of prolonged-release tacrolimus. We have reviewed the literature on the use of prolonged-release tacrolimus and hope that this will be of value in the design of protocols for transplant immunosuppression.

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Medication Non-adherence among Liver Transplant Recipients

Jones

Serper

2020

Curr Hepatology Rep

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Conversion from Twice-Daily to Once-Daily Tacrolimus Administration in Liver Transplant Patient: Results of Long Term Follow-Up

Cited by 7 publications

References 0 publications

Favorable longterm outcomes of liver transplant recipients treated de novo with once‐daily tacrolimus: Results of a single‐center cohort

Favorable longterm outcomes of liver transplant recipients treated de novo with once‐daily tacrolimus: Results of a single‐center cohort

Prevention of organ rejection in renal and liver transplantation with extended release tacrolimus

Medication Non-adherence among Liver Transplant Recipients

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