title: Conversion from twice-daily to once-daily Tacrolimus administration in liver transplant patient: results of long term follow-up.
abstract: OBJECTIVE
  The aim of this study was to assess the long term effects of once-daily tacrolimus (OD-TAC) in a cohort of stable liver recipients converted from the twice daily tacrolimus (TD TAC), with a particular attention on the possible effects on renal function.
  
  
  METHODS
  Between September 2008 and September 2010 conversion from TD-TAC to OD-TAC was proposed in adult stable liver transplant recipients who were followed as outpatients in our Transplant centre. Conversion from TC-TAC to OD-TAC was based on a 1 mg: 1 mg proportion. Tacrolimus through levels, laboratory parameters, metabolic disorders and any adverse events were evaluated at 1, 3, 6, 12 and 24 months after conversion. Renal function was evaluated using creatinine plasma levels and estimated glomerular filtration rate (GFR) derived from the Modification of Diet in Renal Disease (MDRD). Analysis of variance and t test for paired data were utilised for the comparison of the results obtained at the scheduled controls.
  
  
  RESULTS
  Sixty-five patients were enrolled in the study (50 males, 15 females, mean age 59±8 years). Median time since liver transplant (LT) was 39 months (range: 6 to 83 months). All patients were followed for a minimum of 12 months. Ninety per cent of patients stabilized their blood levels within 45 days. Liver function, glucose and plasma lipids concentration and arterial blood pressure remained stable during the study. Renal function improved during the 24 months of follow-up. No adverse events or acute rejection episodes were recorded during the study.
  
  
  CONCLUSIONS
  Considering the advantage on patient compliance, the equivalent efficacy and the adequate safety of OD-TAC formulation may represent a useful option in liver transplant patients, with a possible advantage on renal function.
authors.affiliation: Department of Clinical Medicine, Division of Gastroenterology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. Manuela.merli@uniroma1.it.
authors.forename: V
authors.initials: V
authors.lastname: Giannelli
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: M
authors.initials: M
authors.lastname: Giusto
authors.forename: C
authors.initials: C
authors.lastname: Lucidi
authors.forename: B
authors.initials: B
authors.lastname: Lattanzi
authors.forename: A
authors.initials: A
authors.lastname: Ruffa
authors.forename: S
authors.initials: S
authors.lastname: Ginanni Corradini
authors.forename: G
authors.initials: G
authors.lastname: Mennini
authors.forename: F
authors.initials: F
authors.lastname: Melandro
authors.forename: Q
authors.initials: Q
authors.lastname: Lai
authors.forename: P
authors.initials: P
authors.lastname: Berloco
authors.forename: M
authors.initials: M
authors.lastname: Merli
mesh_terms: D000368:Aged; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007668:Kidney / Q000503:physiopathology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000008:administration & dosage*
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus