Lower tacrolimus trough levels in the late period after living donor liver transplantation contribute to improvements in long-term clinical outcomes
Lei Geng a, Li-Dong Wang a,b,c,d, Jun-Jie Huang a,b,c,d, Tian Shen a, Zhuo-Yi Wang a, Bing-Yi Lin a,b,c,d, Yu-Fu Ye a, Shu-Sen Zheng a,b,c,d,∗
a Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
310003, China
b Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Key Laboratory of Organ Transplantation, Hangzhou 310003, China
c Key Laboratory of Organ Transplantation, Hangzhou 310003, China
d Collaborative Innovation Center for Diagnosis Treatment of Infectious Diseases, Hangzhou 310003, China ∗ Corresponding author at: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
E-mail address: shusenzheng@zju.edu.cn (S.-S. Zheng).
BACKGROUND: Previous studies have emphasized the need to reduce tacrolimus (TAC) trough levels in the early post-liver transplantation (LT) period. However, whether late-period TAC trough levels influence the long-term outcomes of liver recipients is not clear.
METHODS: We enrolled 155 adult liver recipients survived more than 3 years after living donor liver transplantation because of non-malignant liver diseases. The maintenance immunosuppressive regimens were TAC monotherapy and combined therapy with mycophenolate mofetil. Patients were divided into three groups according to their late-period TAC trough levels: < 3?ng/mL group, 3-5?ng/mL group, and >5?ng/mL group. The complications and adverse effects of TAC were analyzed.
RESULTS: Each group showed similar rejection, graft loss and mortality. Patients achieved the?<?5?ng/mL state in less than 4 years had fewer new-onset diabetes, hyperlipidemia, de novo malignancies, and hepatitis B virus recurrence; the complications of renal dysfunction and hypertension rates were the same among these 3 groups.
CONCLUSIONS: Collectively, our findings indicated that lower TAC trough levels in the late period of liver transplantation are safe, improve the long-term outcomes.
. [J]. Hepatobiliary Pancreat Dis Int, 2018, 17(3): 204-209.
Geng L,Wang LD, Huang JJ, Shen T,Wang ZY, Lin BY, Ye YF, Zheng SS. Lower tacrolimus trough levels in the late period after living donor liver transplantation contribute to improvements in long-term clinical outcomes. Hepatobiliary Pancreat Dis Int, 2018, 17(3): 204-209.
2018, Vol. 17 
