Risk Factors for the Adverse Events after Conversion from Twice-Daily to Once-Daily Tacrolimus in Stable Liver Transplantation Patients
Journal of Korean Medical Science
;
: 1711-1716, 2016.
Article
in English
| WPRIM
| ID: wpr-80075
ABSTRACT
Despite the therapeutic equivalence between twice-daily and once-daily tacrolimus, patient safety after conversion is still a concern. We reviewed 218 liver transplantation (LT) patients who converted twice-daily to once-daily tacrolimus between May 2011 and January 2014. Thirty (13.8%) patients had adverse events after conversion, with a liver function test (LFT) abnormality being the most common adverse event (n = 17). Despite the decrease in serum tacrolimus of > 30% after conversion, none of the patients who were converted to a dosage ratio (once-daily tacrolimus dosage twice-daily tacrolimus dosage) > 1 had an LFT abnormality. Most patients with an LFT abnormality improved after increasing the once-daily tacrolimus dosage (n = 2), returned to a previous medication, and/or added another immunosuppressant (n = 15). One patient had acute cellular rejection, which improved after steroid pulse treatment, and another patient had graft failure. In patients with a dosage ratio ≤ 1, the conversion time within 5 years after LT was the only significant risk factor for an LFT abnormality after conversion (odds ratio 11.850, 95% confidence interval 1.321–106.325, P = 0.027). In conclusion, the dosage ratio and time after LT should be carefully considered during conversion from twice-daily to once-daily tacrolimus.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Risk Factors
/
Liver Transplantation
/
Tacrolimus
/
Transplants
/
Patient Safety
/
Liver
/
Liver Function Tests
Type of study:
Etiology study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2016
Type:
Article
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