Conversion From Immediate-Release Tacrolimus to Prolonged-Release Tacrolimus in Stable Heart Transplant Patients: A Retrospective Study
| Autor: | M. Sanz, Luis de la Fuente, I.P. Garrido, Juan F. Delgado, Beatriz Díaz-Molina, Sonia Mirabet, Luis Almenar, José M. Arizón, María G. Crespo-Leiro, Jesús Palomo, Manuel Gómez-Bueno, Francisco González-Vílchez, Diego Rangel-Sousa, Félix Pérez-Villa |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty medicine.medical_treatment Population Gastroenterology Tacrolimus Internal medicine medicine Humans Cumulative incidence education Retrospective Studies Immunosuppression Therapy Transplantation education.field_of_study business.industry Incidence (epidemiology) Incidence Retrospective cohort study Immunosuppression Middle Aged Discontinuation Spain Concomitant Delayed-Action Preparations Heart Transplantation Surgery Female business Immunosuppressive Agents |
| Zdroj: | TRANSPLANTATION PROCEEDINGS r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe RUC. Repositorio da Universidade da Coruña |
| ISSN: | 1873-2623 0041-1345 |
| Popis: | [Abstract] Background Lifelong adherence with post-transplant immunosuppression is challenging, with nonadherence associated with greater acute rejection (AR) risk. Methods 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). Results 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). Conclusions Conversion from IRT to PRT in heart transplant recipients in Spain was associated with no new safety concerns and appropriate immunosuppressive effectiveness. |
| Databáze: | OpenAIRE |
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