*Purpose: The use of extended release tacrolimus (LCPT) allows for slow release of drug and once-daily dosing in transplant recipients. The improved bioavailability and decreased peak and trough levels may be beneficial in simultaneous pancreas-kidney recipients.

*Methods: This is a retrospective study of 39 simultaneous pancreas-kidney recipients who were continued on standard tacrolimus (n=21) or converted to LCPT (n=18) on the third postoperative day. Hemoglobin A1c (HbA1c), tacrolimus and creatinine levels were measured postoperatively. Coefficient of variability (CV = 100*mean/standard deviation) was used as a measure of variability of tacrolimus levels.

*Results: There was no difference in tacrolimus CV in the standard tacrolimus and LCPT groups at 1 month (31.6 vs. 32.4; p=0.87) or 3 months postoperatively (32.6 vs. 31.6; p=0.77). Mean tacrolimus levels were not significantly different at 1 month (10.1 vs. 9.6; p=0.42) or 3 months (9.3 vs. 9.5; p=0.57). Notably there were 5 incidences of acute rejection in the standard group compared to zero episodes in the LCPT group. HbA1c at 3 months was significantly higher in the standard group compared to LCPT (5.6% vs. 4.8%; p=0.01). Mean follow up time was 741 days. There was one patient death in the LCPT group.

*Conclusions: LCPT offers an attractive option for tacrolimus administration for transplant recipients. Significantly lower rates of rejection were observed in patients receiving LCPT. The once a day dosing may allow for improved medication adherence resulting in improved long-term outcomes. Lastly, 3-month HgbA1c was lower in LCPT group, which may suggest less islet toxicity.

« Back to 2019 American Transplant Congress