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Anaphylaxis to CoronaVac, an inactivated vaccine against COVID-19, is extremely rare. We report 12 cases of anaphylaxis after CoronaVac administration, focusing on clinical characteristics and management outcomes. Skin test and graded vaccine challenge were successfully performed in our cases and might be considered if an inactivated vaccine is the only remaining option.
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INTRODUCTION: Long-term transplant outcomes are considered a crucial point for kidney transplantation. Follow-up studies in patients receiving early conversion to once-daily tacrolimus (TAC-OD) are still limited. We aimed to investigate tacrolimus trough level (Cmin), intrapatient variability of tacrolimus dose-normalized Cmin (TAC-Cmin/D), along with other outcomes between twice-daily tacrolimus (TAC-BID) and early converted TAC-OD. MATERIAL AND METHODS: This study was a single center, retrospective, cohort study. All new kidney transplant patients who received tacrolimus and presented an estimated glomerular filtration rate of more than 45 mL/min/1.73 m2 on the day of hospital discharge were included. Studied patients were divided into the standard TAC-BID and patients who were converted from TAC-BID to TAC-OD on the day of hospital discharge. We followed patients for 1 year after transplantation. RESULTS: At the first follow-up visit, Cmin of TAC-OD was significantly lower than that of TAC-BID. However, Cmin and estimated glomerular filtration rate were comparable between TAC-BID and TAC-OD throughout 1-year follow-up. TAC-OD also provided a lower intrapatient variability of TAC-Cmin/D compared with TAC-BID when observed after 6 months post transplantation (17.40% and 23.27% for TAC-OD and TAC-BID, respectively; P = .13). The renal function, as well as other adverse outcomes, was similar between 2 formulations. DISCUSSION: TAC-OD provided a similar Cmin with comparable renal function compared with TAC-BID during 1-year follow-up. In addition, TAC-OD is likely to have a benefit of a lower intrapatient variability of tacrolimus. CONCLUSION: Early conversion from TAC-BID to TAC-OD with 1:1 ratio can be used with close long-term monitoring.
