Safe One-to-One Dosage Conversion From Twice-Daily to Once-Daily Tacrolimus in Long-Term Stable Recipients After Liver Transplantation
Yi-Ju Wu, Yu-Hung Lin, Chee-Chien Yong, Wei-Feng Li, Shih-Ho Wang, Chih-Chi Wang, Ting-Lung Lin, Chao-Long Chen, Chih-Che Lin
Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Ann Transplant 2016; 21:30-34
Once-daily tacrolimus provides better compliance for transplant recipients. However, the conversion strategies of dosage and concentration from twice- to once-daily are not well studied. The aim of this study was to investigate the dosage of conversion, follow-up strategy, and safety of conversion to once-daily tacrolimus in stable and long-term recipients after living donor liver transplantation (LDLT).
MATERIAL AND METHODS: From January 2011 to November 2012, we selectively converted 35 stable LDLT recipients to once-daily tacrolimus based on 1-to-1 daily dose. The tacrolimus dosage, trough level, liver and renal function before conversion, 1 month, 3 months, 6 months, and 1 year after conversion were recorded.
RESULTS: Tacrolimus trough level dropped significantly after conversion (2.72±1.65 to 1.85±1.25 ng/mL, p<0.001). No biopsy-proved rejection was detected during 1-year follow-up. However, 1 recipient (2.9%) had a 0.5 mg increase due to elevated liver enzymes and clinically diagnosed rejection. No other patients required dose adjustment due to dropped tough level after conversion.
CONCLUSIONS: One-to-one dosage conversion in stable LDLT recipients is a safe strategy. Dropped trough level is expected and dose adjustment is rarely required.
Keywords: Liver Transplantation, Tacrolimus, Transplantation