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Safety of Tacrolimus Monotherapy within 12 Months after Liver Transplantation in the Era of Reduced Tacrolimus and Mycophenolate Mofetil: National Registry Study

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Author(s)
Deok Gie KimSung Hwa KimShin HwangSuk Kyun HongJe Ho RyuBong-Wan KimYoung Kyoung YouDonglak ChoiDong-Sik KimYang Won NahJai Young ChoTae-Seok KimGeun HongDong Jin JooMyoung Soo KimJong Man KimJae Geun Lee
Keimyung Author(s)
Kim, Tae Seok
Department
Dept. of Surgery (외과학)
Journal Title
J Clin Med
Issued Date
2022
Volume
11
Issue
10
Keyword
liver transplantationtacrolimusmycophenolate mofetilrenal dysfunctiontime-conditional propensity score
Abstract
Tacrolimus monotherapy is accepted as a feasible option during early post-liver transplantation as per current international consensus guidelines. However, its effects in the recent era of reduced tacrolimus (TAC) and mycophenolate mofetil (MMF) remain unclear. Liver recipients who either received TAC monotherapy from the treatment onset or switched from TAC/MMF to TAC-mono within 12 months (TAC-mono group; n = 991) were chronologically matched to patients who continued to receive TAC/MMF (TAC/MMF group; n = 991) at the corresponding time points on time-conditional propensity scores. Outcomes within 12 months after matched time points were compared. Biopsy-proven rejection (TAC/MMF: 3.5% vs. TAC-mono: 2.6%; p = 0.381) and graft failure (0.2% vs. 0.7%; p = 0.082) were similar in both groups. However, the decline in eGFR was 3.1 mL/min/1.73 m2 (95% CI: 0.8–5.3) greater at six months (p = 0.008) and 2.4 mL/min/1.73 m2 (95% CI: −0.05–4.9) greater at 12 months (p = 0.048) after the matched time points in TAC-mono group than that in TAC/MMF group. TAC trough levels were also higher in the TAC-mono group throughout the study period. TAC-mono within 12 months after liver transplantation is immunologically safe. However, it can increase the required TAC dose and the decline in renal function than that in TAC/MMF combination therapy.
Keimyung Author(s)(Kor)
김태석
Publisher
School of Medicine (의과대학)
Citation
Deok Gie Kim et al. (2022). Safety of Tacrolimus Monotherapy within 12 Months after Liver Transplantation in the Era of Reduced Tacrolimus and Mycophenolate Mofetil: National Registry Study. J Clin Med, 11(10), 2806. doi: 10.3390/jcm11102806
Type
Article
ISSN
2077-0383
Source
https://www.mdpi.com/2077-0383/11/10/2806
DOI
10.3390/jcm11102806
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44326
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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