Once Daily Prolonged-Release Tacrolimus in de Novo Renal Transplantation: A Single-Center Experience

Abstract

Background: A prolonged release formulation of tacrolimus may prove to be especially beneficial for transplant recipients in regard to compliance. The aim of this study was to show the results obtained in our center, analyzing the safety, efficacy, blood trough levels, and drug doses. Methods: We retrospectively reviewed data from 22 recipients of renal transplantation which were performed between February 2009 and November 2011. All recipients received initial immunosuppression with once daily tacrolimus assossiated with mycophenolic acid, steroids, and basiliximab. Efficacy and safety variables were collected as the incidence of acute rejection episodes, patient and graft survivals, kidney function as well as incidences of diabetes mellitus. Moreover, we collected result of therapeutic drug monitoring (TDM) of tacrolimus in de novo kidney transplants. Results: Patient and graft survivals were 100%, and the mean serum creatinine level was 1.49 ± 0.77 mg/dL. The incidence of biopsy proven acute rejection episodes was 18.2% (n = 4). Although the rate of diabetes mellitus de novo was 23.8% (n = 5), all recipients lead to improve with no medication. Although we experienced a case of nephrotoxicity causing acute renal failure in early post renal transplantation period, renal function improved by modifying dose of tacrolims. One recipient developed polyoma virus nephropathy. There was a strong correlation between AUC0-24 and Cmin. Conclusion: Once daily prolonged-release tacrolimus have advantage to improve adherence. The good results for patient and graft survival with few side effects make it a useful drug for de novo kidney transplantation