Marubashi Shigeru, Wada Hiroshi, Kobayashi Shogo, Eguchi Hidetoshi, Tanemura Masahiro, Umeshita Koji, Doki Yuichiro, Mori Masaki, Nagano Hiroaki
Department of Surgery, Osaka University, Osaka, Japan.
Hepatogastroenterology. 2012 Jun;59(116):1184-8. doi: 10.5754/hge11623.
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.
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).
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.
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.
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。
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)。
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。
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。