Conversion From Immediate-Release Tacrolimus to Prolonged-Release Tacrolimus in Stable Heart Transplant Patients : A Retrospective Study
González-Vílchez, Francisco (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Delgado, Juan F. (Hospital 12 de Octubre (Madrid))
Palomo, Jesús (Hospital General Universitario Gregorio Marañón)
Mirabet Pérez, Sonia (Institut d'Investigació Biomèdica Sant Pau)
Díaz-Molina, Beatriz (Hospital Universitario Central de Asturias)
Almenar Bonet, Luis (Hospital Universitari i Politècnic La Fe (València))
Arizón, J. M (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Rangel-Sousa, Diego (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Pérez-Villa, Félix (Hospital Clínic i Provincial de Barcelona)
Garrido, Iris P. (Hospital Universitario Virgen de la Arrixaca (Múrcia))
de la Fuente Galán, Luis (Hospital Universitario Clínico de Valladolid)
Gómez-Bueno, Manuel (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Sanz, María L. (Hospital Universitario Miguel Servet (Saragossa))
Crespo-Leiro, Maria Generosa (Instituto de Investigación Biomédica de A Coruña)
Universitat Autònoma de Barcelona

Date:	2019
Abstract:	Lifelong adherence with post-transplant immunosuppression is challenging, with nonadherence associated with greater acute rejection (AR) risk. This retrospective study evaluated conversion from immediate-release tacrolimus (IRT) to prolonged-release tacrolimus (PRT), between January 2008 and December 2012 in stable adult heart transplant recipients. Cumulative incidence rate (IR) of AR and infection pre- and postconversion, safety, tacrolimus dose and trough levels, concomitant immunosuppression, and PRT discontinuation were analyzed (intention-to-treat population). Overall, 467 patients (mean age, 59. 3 [SD, 13. 3] years) converted to PRT at 5. 1 (SD, 4. 9) years post transplant and were followed for 3. 4 (SD, 1. 5) years. During the 6 months post conversion, 5 patients (1. 1%; 95% CI, 0. 35%-2. 48%) had an AR episode and IR was 2. 2/100 patient-years (95% CI, 0. 91-5. 26). Incidence of rejection preconversion varied by time from transplant to conversion. Infection IR was similar post- and preconversion (9. 2/100 patient-years [95% CI, 7. 4-11. 3] vs 10. 6/100 patient-years [95% CI, 8. 8-12. 3], respectively; P =. 20). Safety variables remained similar post conversion. The IR of mortality/graft loss was 2. 3/100 patient-years (95% CI, 1. 7-3. 1). Conversion from IRT to PRT in heart transplant recipients in Spain was associated with no new safety concerns and appropriate immunosuppressive effectiveness.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Transplantation Proceedings, Vol. 51 Núm. 6 (july 2019) , p. 1994-2001, ISSN 1873-2623

DOI: 10.1016/j.transproceed.2019.04.028
PMID: 31227301

8 p, 444.1 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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