Pediatric Hepatology and Liver Transplant Unit, Hospital Universitari de la Vall d'Hebron, Universitat Atònoma de Barcelona, 08036, Barcelona, Spain.
Hepatology and Liver Transplant Unit, Hospital Universitari de la Vall d'Hebron, Universitat Atònoma de Barcelona, 08036, Barcelona, Spain.
Transpl Int. 2018 Jan;31(1):38-44. doi: 10.1111/tri.13037. Epub 2017 Sep 27.
To assess the safety and efficacy of conversion from twice-daily tacrolimus to once-daily tacrolimus in pediatric liver transplant recipients. Conversion from twice-daily to once-daily tacrolimus was made in stable pediatric liver transplant recipients. Doses and serum levels of tacrolimus, liver, and renal function were recorded on the day before the conversion and at days 5, 30, 90, and 180 postconversion. Patients were controlled every 2-3 months thereafter. Fifty-five patients were enrolled in the study. The mean age at conversion was 10.2 ± 3.6 years. The mean tacrolimus trough level was 4.7 ± 1.9 ng/dl preconversion, followed by a significant decline to 4.2 ± 1.7 30 days after the switch (P < 0.004). Mean daily tacrolimus dose was 0.09 ± 0.046 mg/Kg preconversion with a significant increase to 0.11 ± 0.060 3 months postconversion (P < 0.001). Fifteen patients with calculated glomerular filtration rate between 60 to 80 ml/min/m preconversion showed a significant improvement one and 3 years after the switch (73 ± 4.1, 83 ± 4.3 and 90.3 ± 7.3 ml/min/m , respectively (P < 0.001). The mean follow-up was 5.2 ± 2.4 years. Conversion to once-daily tacrolimus is safe and effective in a cohort of stable pediatric liver transplant patients.
评估将每日两次的他克莫司转换为每日一次在小儿肝移植受者中的安全性和疗效。在稳定的小儿肝移植受者中进行从每日两次到每日一次的他克莫司转换。在转换前一天和转换后第 5、30、90 和 180 天记录他克莫司的剂量和血清水平、肝肾功能。此后每 2-3 个月对患者进行一次控制。共有 55 名患者入组研究。转换时的平均年龄为 10.2 ± 3.6 岁。转换前他克莫司谷浓度的平均值为 4.7 ± 1.9ng/dl，转换后 30 天显著下降至 4.2 ± 1.7ng/dl（P < 0.004）。转换前平均每日他克莫司剂量为 0.09 ± 0.046mg/Kg，转换后 3 个月显著增加至 0.11 ± 0.060mg/Kg（P < 0.001）。转换前肾小球滤过率（GFR）在 60-80ml/min/m 之间的 15 名患者在转换后 1 年和 3 年时显示出显著改善（分别为 73 ± 4.1、83 ± 4.3 和 90.3 ± 7.3ml/min/m，P < 0.001）。平均随访时间为 5.2 ± 2.4 年。在稳定的小儿肝移植患者队列中，将他克莫司转换为每日一次是安全有效的。
