scholarly journals A Comparative Analysis Of Once-Daily And Twice-Daily Formulation Of Tacrolimus In De Novo Kidney Transplant Recipients

2020 ◽  
Author(s):  
Murat Ferhat Ferhatoglu ◽  
Abdulcabbar Kartal ◽  
Ali Ilker Filiz ◽  
Gursel Yildiz ◽  
Alp Gurkan
Keyword(s):  
Clinical Practice ◽  
Kidney Transplant ◽  
Blood Concentration ◽  
De Novo ◽  
Graft Function ◽  
Early Postoperative Period ◽  
Kidney Transplant Recipients ◽  
Blood Concentrations ◽  
Once Daily ◽  
Kidney Recipients

Abstract Objectives: Once-daily formulation of tacrolimus has begun to find a place in daily clinical practice as similar efficacy and safety profile as the twice-daily formulation according to clinical trials. However, few numbers of un-sponsored, non-trial studies are issued centering on its usage in clinical practice. We compared once-daily and twice-daily formulation of tacrolimus in terms of the efficiency and effects on graft function in de novo kidney transplant patients.Methods: Twenty once-daily (TAC-OD) and twenty twice-daily (TAC-BID) tacrolimus administrated de novo kidney recipients who had received initial immunosuppressive therapy according to protocols at our institution (0.2 mg/kg of tacrolimus combined with 1000 milligrams of steroid taper plus 720 mg of mycophenolate and with 2,5mg/kg human immune globulin) assessed in terms of demographics, drug doses and blood concentration, and graft function. Results: The mean tacrolimus blood concentration measurements were higher in the TAC-OD group in the first sixty days after transplantation, and the TAC-OD group showed more blood concentration overshoots in the first 30 days of the treatment. The initial drug dose was significantly higher in the TAC-OD group compared to the TAC-BID group (p=0.04). There was no meaningful difference among groups according to graft function (creatinine measurements) (p>0.05).Conclusion: Between de novo kidney recipients, the new TAC-OD formulation presents a similar short-term efficacy profile as TAC-BID. However, a higher daily dosage of TAC-OD is needed to achieve similar blood concentrations in the early postoperative period.

scholarly journals Bioavailability of once‐daily tacrolimus formulations used in clinical practice in the management of De Novo kidney transplant recipients: the better study

2021 ◽  
Author(s):  
Constantino Fernandez Rivera ◽  
María Calvo Rodríguez ◽  
José Luís Poveda ◽  
Julio Pascual ◽  
Marta Crespo ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Kidney Transplant ◽  
De Novo ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Once Daily

scholarly journals Immunosuppression minimization in kidney transplant recipients hospitalized for COVID-19

2021 ◽  
Author(s):  
Paula Anton Pampols ◽  
Hernando Trujillo ◽  
Edoardo Melilli ◽  
Blanca Urban ◽  
Justo Sandino ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
De Novo ◽  
Graft Function ◽  
Immunosuppressive Agent ◽  
Immunosuppressive Drugs ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Immunosuppressed Patients ◽  
The Impact

Abstract Background Immunosuppressed patients such as kidney transplant recipients (KTs) have increased mortality risk in the setting of coronavirus disease 2019 (COVID-19). The role and management of chronic immunosuppressive therapies during COVID-19 must be characterized. Methods Herein, we report the follow-up of a cohort of 47 KTs admitted at two Spanish Kidney Transplant Units, who survived COVID-19. The impact of the management of immunosuppression during COVID-19 on graft function and immunologic events was evaluated. Results At least one immunosuppressive agent was withdrawn in 83% of patients, with antimetabolites being the most frequent. Steroids were generally not stopped and the dose was even increased in 15% of patients as part of the treatment of COVID-19. Although immunosuppressive drugs were suspended during a median time of 17 days, no rejection episodes or de novo donor-specific antibodies were observed up to 3 months after discharge, and no significant changes occurred in calculated panel reactive antibodies. Acute graft dysfunction was common (55%) and the severity was related to tacrolimus trough levels, which were higher in patients receiving antivirals. At the end of follow-up, all patients recovered baseline kidney function. Conclusions Our observational study suggests that immunosuppression in KTs hospitalized due to COVID-19 could be safely minimized.

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