Transplant Trial Watch

The Conversion of Once-daily Extended-release Tacrolimus is Safe in Stable Liver Transplant Recipients: A Randomized Prospective Study.

Kim JM, Kwon CH, et al.

Liver Transpl 2015 [record in progress]


Aims
To compare the efficacy and safety of once-daily extended-release tacrolimus regimen and twice-daily tacrolimus regimen in stable liver transplant recipients.

Interventions
Patients were randomly assigned to either remain on a twice-daily tacrolimus regimen, or be converted to a once-daily regimen.

Participants
94 recipients of a primary liver transplant from a deceased or living donor who were at least 12 months posttransplant, aged >20 years with stable liver function and receiving a calcineurin inhibitor

Outcomes
The primary outcome measured was the proportion of patients with biopsy-proven acute rejection within 6 months. Secondary outcomes measured included graft failure, mortality, adverse events, blood pressure, and serum tacrolimus levels.

Follow-up
24 weeks

CET Conclusions
This non-inferiority, single-centre Korean trial evaluated late conversion (≥ 1 year) of 94 stable liver transplant patients from conventional twice-daily tacrolimus to once-daily, extended-release tacrolimus. Sample size calculations, method of randomisation and whether allocation was concealed were not described. After six months, graft and patient survival were 100% in both groups. There were no episodes of acute rejection and no safety concerns. These short-term data suggest that it is safe to convert stable liver transplant recipients to once-daily tacrolimus but long-term follow up of these patients is needed.

Jadad score
2

Data analysis
Modified intention-to-treat analysis

Allocation concealment
No

Trial registration
Clinical Research Information Service database - KCT0000478

Funding source
Industry funded