Short- and Long-term Outcomes of De Novo Liver Transplant Patients Treated With Once-Daily Prolonged-Release Tacrolimus

Yuichiro Okumura, MD; Takehiro Noda, MD, PhD; Hidetoshi Eguchi, MD, PhD; Yoshifumi Iwagami, MD, PhD; Daisaku Yamada, MD, PhD; Tadafumi Asaoka, MD, PhD; Hiroshi Wada, MD, PhD; Koichi Kawamoto, MD, PhD; Kunihito Gotoh, MD, PhD; Yutaka Takeda, MD, PhD; Masahiro Tanemura, MD, PhD; Shigeru Marubashi, MD, PhD; Koji Umeshita, MD, PhD; Yuichiro Doki, MD, PhD; Masaki Mori, MD, PhD

doi:10.1097/TXD.0000000000000722

Transplantation Direct (Sep 2017)

Short- and Long-term Outcomes of De Novo Liver Transplant Patients Treated With Once-Daily Prolonged-Release Tacrolimus

Yuichiro Okumura, MD,
Takehiro Noda, MD, PhD,
Hidetoshi Eguchi, MD, PhD,
Yoshifumi Iwagami, MD, PhD,
Daisaku Yamada, MD, PhD,
Tadafumi Asaoka, MD, PhD,
Hiroshi Wada, MD, PhD,
Koichi Kawamoto, MD, PhD,
Kunihito Gotoh, MD, PhD,
Yutaka Takeda, MD, PhD,
Masahiro Tanemura, MD, PhD,
Shigeru Marubashi, MD, PhD,
Koji Umeshita, MD, PhD,
Yuichiro Doki, MD, PhD,
Masaki Mori, MD, PhD

Affiliations

Yuichiro Okumura, MD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Takehiro Noda, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Hidetoshi Eguchi, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Yoshifumi Iwagami, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Daisaku Yamada, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Tadafumi Asaoka, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Hiroshi Wada, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Koichi Kawamoto, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Kunihito Gotoh, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Yutaka Takeda, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Masahiro Tanemura, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Shigeru Marubashi, MD, PhD: 4 Department of Regenerative Surgery, Fukushima Medical University, Fukushima, Japan.
Koji Umeshita, MD, PhD: 5 Division of Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan.
Yuichiro Doki, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Masaki Mori, MD, PhD: 1 Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.

DOI: https://doi.org/10.1097/TXD.0000000000000722
Journal volume & issue: Vol. 3, no. 9
p. e207

Abstract

Read online

Background. Tacrolimus is the key immunosuppressive drug for liver transplantation. Once-daily prolonged-release tacrolimus (TAC-PR) exhibits good drug adherence but has difficulty controlling the trough level in the early phase of liver transplantation. The aim of this study was to compare the feasibility and efficacy of immediately starting oral TAC-PR versus traditional twice-daily tacrolimus (TAC-BID) in de novo liver transplantation recipients. Methods. The study included 28 patients treated with conventional TAC-BID and 60 patients treated with TAC-PR (median follow-up 70.5 months). Short-term and long-term outcomes were compared. Results. Patient characteristics were similar except for the incidence of hepatocellular carcinoma and type of graft. Dose adjustment was more frequently required for TAC-PR than TAC-BID (73.3% vs 42.9%, P = 0.006), but trough levels of TAC during the first 3 months after liver transplantation were controlled well in both groups. The rate of acute cellular rejection and long-term renal function were similar in both groups. In both groups, renal function worsened during the first 6 months after transplantation and remained stable until the end of the follow-up period. The 1-year, 3-year, and 5-year survival rates were 96.4%, 85.7%, and 85.7% for TAC-BID and 96.7%, 94.8%, and 94.8% for TAC-PR, respectively. The overall survival curve for TAC-PR was not inferior to that of TAC-BID. Conclusions. The TAC-PR protocol was feasible and effective with strict adjustment.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

About the journal