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每日一次缓释他克莫司用于初次肝移植:一项单中心队列研究。

Once-daily prolonged-release tacrolimus in de novo liver transplantation: a single center cohort study.

作者信息

Marubashi Shigeru, Wada Hiroshi, Kobayashi Shogo, Eguchi Hidetoshi, Tanemura Masahiro, Umeshita Koji, Doki Yuichiro, Mori Masaki, Nagano Hiroaki

机构信息

Department of Surgery, Osaka University, Osaka, Japan.

出版信息

Hepatogastroenterology. 2012 Jun;59(116):1184-8. doi: 10.5754/hge11623.

Abstract

BACKGROUND/AIMS: The feasibility of oral administration of once-daily prolonged-release tacrolimus (TAC-PR) in de novo liver transplantation is not clear and therefore was investigated further.

METHODOLOGY

The clinical profiles of 16 consecutive primary living donor liver transplantation (LDLT) recipients, who received oral TAC-PR once daily (TAC-PR group) between January 2009 and August 2010, were compared with those of 14 consecutive liver transplantation recipients given twice-daily tacrolimus (TAC; TAC group) between August 2006 and January 2009. Of the 14 patients in the TAC group, 9 received LDLT (TAC-L subgroup).

RESULTS

Patient characteristics were similar between groups. Trough levels of TAC during the first 3 months after liver transplantation were well-adjusted in both groups. Dose adjustment was more frequently required (31.3%) in the TAC-PR group and the total amount of TAC was significantly higher in the TAC-PR group (181.1±75.3mg) than in the TAC-L group (100.2±53.8mg, p=0.014). The incidence of biopsy-proven acute cellular rejection, renal dysfunction, other morbidities and hospital stay length were similar between groups.

CONCLUSIONS

Oral administration of TAC-PR for de novo liver transplantation recipients was well tolerated with similar safety and efficacy profiles as traditional twice-daily TAC with closely controlled adjustment of the TAC-PR dose.

摘要

背景/目的:肝移植受者口服每日一次的缓释他克莫司(TAC-PR)的可行性尚不清楚,因此进行了进一步研究。

方法

将2009年1月至2010年8月期间连续16例接受每日一次口服TAC-PR的初次活体供肝移植(LDLT)受者(TAC-PR组)的临床资料,与2006年8月至2009年1月期间连续14例接受每日两次他克莫司(TAC;TAC组)的肝移植受者的临床资料进行比较。TAC组的14例患者中,9例接受了LDLT(TAC-L亚组)。

结果

两组患者的特征相似。肝移植后前3个月TAC的谷浓度在两组中均得到良好调整。TAC-PR组更频繁地需要调整剂量(31.3%),且TAC-PR组的TAC总量(181.1±75.3mg)显著高于TAC-L组(100.2±53.8mg,p=0.014)。两组间活检证实的急性细胞排斥反应、肾功能不全、其他疾病的发生率及住院时间相似。

结论

肝移植受者口服TAC-PR耐受性良好,其安全性和有效性与传统的每日两次TAC相似,且TAC-PR剂量调整严格。

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