Correlation between optimal tacrolimus doses and the graft weight in living donor liver transplantation

Sugawara, Yasuhiko; Makuuchi, Masatoshi; Kaneko, Junichi; Ohkubo, Takao; Imamura, Hiroshi; Kawarasaki, Hideo

doi:10.1034/j.1399-0012.2002.1o106.x

Cited by 86 publications

(63 citation statements)

References 10 publications

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“…13 Briefly, immunosuppressive drugs consisted of tacrolimus and methylprednisolone. 14 On discharge, all patients were followed-up twice a month for 1 year after LDLT and monthly thereafter at the outpatient clinic. Posttransplantation chemotherapy was not administered to any of the 13 patients with HCC.…”

Section: Postoperative Evaluationmentioning

confidence: 99%

Living donor liver transplantation for hepatitis B cirrhosis

Sugawara¹,

Makuuchi²,

Kaneko³

et al. 2003

Liver Transplantation

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The living donor liver transplantation (LDLT) experience for patients with hepatitis B virus (HBV) infection is still limited. Because LDLT can be performed electively, it can provide an appropriate length of time to reduce HBV DNA levels before the operation. This study aims to examine the feasibility of our protocol for preventing HBV reinfection after LDLT. Of 20 patients analyzed, 15 patients had detectable serum HBV DNA when referred to our hospital. Thirteen patients had hepatocellular carcinoma. All patients were treated with lamivudine (100 mg/d) before LDLT. After LDLT, hepatitis B immunoglobulin (HBIG) was administered to maintain serum antibody to hepatitis B surface antigen titers at greater than 1,000 IU/mL for 1 year and 200 IU/mL thereafter. Lamivudine was not administered postoperatively, except for three patients with detectable serum HBV DNA just before LDLT. All patients survived the operation. One patient died 229 days after LDLT of carcinoma recurrence. In the other 19 patients, liver function has remained normal and no viral relapse occurred postoperatively during a median follow-up of 19 months. Perioperative use of lamivudine and indefinite HBIG administration in the postoperative period might be a rational strategy for preventing HBV reinfection after LDLT.

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Section: Postoperative Evaluationmentioning

confidence: 99%

Living donor liver transplantation for hepatitis B cirrhosis

Sugawara¹,

Makuuchi²,

Kaneko³

et al. 2003

Liver Transplantation

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“…SFS grafts have a relatively small liver mass because the GRBW is less than 0.8% and severe ischemic injuries caused by decreased hepatic arterial inflow or even hepatic artery thrombosis can occur [13][14][15] . Fukatsu et al [8] reported that graft hepatic weight was significantly correlated with clearance of tacrolimus in adult patients who had undergone LDLT, and Sugawara et al [16] reported that the optimal tacrolimus dose was best correlated with GV/SV ratio. Lee et al [17] reported that the clearance of tacrolimus was related to GRWR and the clearance of tacrolimus was decreased in patients with a small graft.…”

Section: Discussionmentioning

confidence: 99%

Tacrolimus dosage requirements in living donor liver transplant recipients with small-for-size grafts

Liu¹,

Li²,

Xiang³

et al. 2009

WJG

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AIM:To investigate the tacrolimus dosage requirements and blood concentrations in adult-to-adult right lobe living donor liver transplantation (AALDLT) recipients with small-for-size (SFS) grafts. METHODS:During January 2007 and October 2008, a total of 54 cases of AALDLT with an observation period of 6 mo were enrolled in this study. The 54 patients were divided into two groups according to graftrecipient body weight ratio (GRBW): SFS grafts group (Group S, GRBW < 0.8%, n = 8) and non-SFS grafts group (Group N, GRBW ≥ 0.8%, n = 46). Tacrolimus 12-hour blood levels and doses were recorded during weeks 1, 2, 3 and 4 and months 2, 3, 4, 5 and 6 in group S and group N. Meanwhile, acute rejection rates, liver and renal function test results, and the number of potentially interacting medications were determined at each interval in the two groups. A comparison of tacrolimus dosage requirements and blood levels were made weekly in the first month post-surgery, and monthly from months 2 to 6. RESULTS:There were no differences in the demographic characteristics, acute rejection rates, liver and renal function test results, or the number of potentially interacting medications administered between the two groups. The tacrolimus dosage requirements in group S were significantly lower than group N at 2 wk (2.8 ± 0.4 mg/d vs 3.6 ± 0.7 mg/d, P = 0.006), 3 wk (2.9 ± 0.7 mg/d vs 3.9 ± 0.8 mg/d, P = 0.008), 4 wk (2.9 ± 0.8 mg/d vs 3.9 ± 1.0 mg/d, P = 0.023) and 2 mo (2.8 ± 0.7 mg/d vs 3.8 ± 1.1 mg/d, P = 0.033). Tacrolimus 12-h trough concentrations were similar between the two groups at all times except for 2 wk post-transplantation, when the concentrations were significantly greater in group S recipients than in group N recipients (11.3 ± 4.8 ng/mL vs 7.0 ± 3.8 ng/mL, P = 0.026).CONCLUSION: SFS grafts recipients have significantly decreased tacrolimus dosage requirements compared with non-SFS grafts recipients in AALDLT during the first 2 mo post-surgery.

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“…Similar to the majority of liver transplantation centers worldwide (6), this institution uses a tacrolimus-based immunosuppression regimen. All of patients included in the present study initially received the same immunosuppressive regimen with TAC and methylprednisolone (7). In brief, TAC was administered by continuous intravenous infusion at a dose of 2.5 ug/kg/h just after surgery.…”

Section: Methodsmentioning

confidence: 99%