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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). |
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Abstract
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.
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