*Purpose: Taiwan has a high prevalence of hepatitis B (HBV) and HBV related end-stages liver diseases are the leading causes of liver transplantation (LT). Tenofovir alafenamide (TAF) is a recently approved agent for the treatment of chronic HBV and has demonstrated improved renal profiles compared with tenofovir disoproxil fumarate (TDF) in multinational phase III trials. The aim of this study was to assess the outcomes of TAF treatment in LT recipients.

*Methods: This retrospective study analyzed 23 LT patients who received treatment with TDF and TAF at a single reference center. Change from baseline in renal function were compared.

*Results: At Chang Gung Memorial Hospital Linkou, 23 LT recipients received TDF for ≥ 48 weeks and switched to TAF. 14 patients received living donor LT, 7 patients deceased whole LT and 2 patients split LT. At the time of transplantation, median Model of End-Stage Liver Disease (MELD) score was 20 (interquartile range, IQR 10-27). Median duration of treatment with TDF was 1114 days (range 84-2141). During treatment with TDF, the estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) significantly decreased at weeks 24 and 48 (mean level 12.71 ± 23.36 and 15.13± 15.79 mL/min/1.73m² for week 24 and 48, p=0.016 and <0.001 respectively). After switching to TAF, at week 24, mean eGFR_MDRD change was 5.96 ± 11.62 mL/min/1.73m², p=0.029. Before conversion to TAF, 7 patients remained hepatitis B surface antigen (HBsAg) positive after transplantation and 4 patients experienced HBV reactivation. One patient became HBsAg negative 52 weeks after treatment. No patients discontinued TDF or TAF due to side effects.

*Conclusions: In our LT recipients, switching from TDF to TAF led to significant early improvement in renal function.

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