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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.
Artigo em Inglês | 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.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Fatores de Risco / Transplante de Fígado / Tacrolimo / Transplantes / Segurança do Paciente / Fígado / Testes de Função Hepática Tipo de estudo: Estudo de etiologia / Fatores de risco Limite: Humanos Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2016 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Fatores de Risco / Transplante de Fígado / Tacrolimo / Transplantes / Segurança do Paciente / Fígado / Testes de Função Hepática Tipo de estudo: Estudo de etiologia / Fatores de risco Limite: Humanos Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2016 Tipo de documento: Artigo