Comuzzi C, Lorenzin D, Rossetto A, Faraci M G, Nicolini D, Garelli P, Bresadola V, Toniutto P, Soardo G, Baroni G S, Adani G L, Risaliti A, Baccarani U
Department of Tissue and Organ Transplantation, University Hospital of Udine, Italy.
Transplant Proc. 2010 May;42(4):1320-1. doi: 10.1016/j.transproceed.2010.03.106.
Nonadherence to immunosuppressive regimens among solid organ transplantation to range has been estimated from 15% to 55%. This problem has been identified as a leading cause of preventable graft loss. Tacrolimus once daily Advagraf has been developed to provide a more convenient dosing regimen to improve adherence. The aim of this study was to analyze the safety of a 1:1 dose conversion from twice-daily tacrolimus (Prograf) to Advagraf in 36 stable liver transplant recipients. The tacrolimus whole blood trough level at T0 was 6.7 +/- 2.9 ng/mL with a daily dose of 3.7 +/- 1.8 mg. The mean tacrolimus blood trough levels at T1 (7 days) and T2 (14 days) were 5.8 +/- 2.5 and 5.8 +/- 1.8 ng/mL with mean daily doses of 3.9 +/- 1.9 and 4.1 +/- 1.8 mg, respectively. There was no significant difference between T0, T1, and T2, either for tacrolimus blood trough levels or for tacrolimus daily dosages. Liver and renal function tests remained stable; no episodes of acute rejection were encountered after the conversion. A switching policy using a dose ratio of 1:1 from twice-daily tacrolimus to once-daily prolonged-release tacrolimus was safely applied to stable liver transplant recipients.
实体器官移植中免疫抑制方案的不依从率估计在15%至55%之间。这个问题已被确认为可预防移植物丢失的主要原因。他克莫司每日一次的Advagraf已被开发出来，以提供更方便的给药方案来提高依从性。本研究的目的是分析36例稳定的肝移植受者从每日两次他克莫司（Prograf）转换为Advagraf 1:1剂量转换的安全性。T0时他克莫司全血谷浓度为6.7±2.9 ng/mL，日剂量为3.7±1.8 mg。T1（7天）和T2（14天）时他克莫司平均血谷浓度分别为5.8±2.5和5.8±1.8 ng/mL，平均日剂量分别为3.9±1.9和4.1±1.8 mg。T0、T1和T2之间，无论是他克莫司血谷浓度还是他克莫司日剂量，均无显著差异。肝肾功能检查保持稳定；转换后未发生急性排斥反应。一种从每日两次他克莫司到每日一次缓释他克莫司的1:1剂量转换策略被安全地应用于稳定的肝移植受者。
