A Six-Month, Prospective, Single-Center, Pilot Study to Determine the Pharmacokinetics and Effectiveness of Immunosuppressant Regimens in Liver Transplantation Patients Receiving Twice-Daily Tacrolimus and Everolimus (TAC + EVR BID) Regimen Converted to Once-Daily Tacrolimus and Everolimus (TAC + EVR QD) Regimen – A Priliminary Report
Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan.
Meeting: 2018 American Transplant Congress
Abstract number: C214
Keywords: Efficacy, Immunosuppression, Liver, Pharmacokinetics
Session Information
Session Name: Poster Session C: Liver: Immunosuppression and Rejection
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Adherence to immunosuppressant regimen is crucial for graft survival and usually inversely related to the dose frequency. Similar efficacy and safety profile has been approved for once-daily(QD) TAC. EVR QD dosing has also shown the comparable result for renal transplant. We examined the pharmacokinetics(PK) and efficacy of liver transplant recipients receiving twice-daily TAC+EVR regimen(BID) and then being shift to QD dosing.
The study enrolled ten adult patients who received de novo liver transplant within 6 months and used TAC+EVR BID regimen and eGFR≥30 ml/min/1.73 m2. The primary end point was the PK study of TAC+EVR under BID and QD dosing. The blood sample of PK study were obtained at pre-morning dosing (0 hr) and 1,2,3,4,5,6,8,10,12,16,24 hrs after drug administration. TAC+EVR was shift to QD dosing by 1:1 proportion. PK study of QD dosing was performed after 2 weeks. 
The secondary end points were treatment failure, report of adverse events(AE), and measurement of eGFR. The drug level of TAC and EVR level BID and QD dosing in first 2 patients was similar.
The graft function and eGFR were comparable
| AST(U/L) | ALT(U/L) | Total Bilirubin(mg/dL) | INR | eGFR (ml/min/1.73m2) | |
| P't 1 (BID/QD) | 21/22 | 12/12 | 0.6/0.6 | 1.0/1.0 | >60/57 |
| P't 2 (BID/QD) | 22/23 | 14/12 | 1.0/0.5 | 1.1/1.0 | >60/>60 |
Our preliminary data suggested that shift TAC+EVR from BID to QD dosing could be considered.
CITATION INFORMATION: Wu T-.H., Cheng C-.H., Wang Y-.C., Lee C-.F., Wu T-.J., Chou H., Chan K-.M., Lee W-.C. A Six-Month, Prospective, Single-Center, Pilot Study to Determine the Pharmacokinetics and Effectiveness of Immunosuppressant Regimens in Liver Transplantation Patients Receiving Twice-Daily Tacrolimus and Everolimus (TAC + EVR BID) Regimen Converted to Once-Daily Tacrolimus and Everolimus (TAC + EVR QD) Regimen – A Priliminary Report Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Wu T-H, Cheng C-H, Wang Y-C, Lee C-F, Wu T-J, Chou H, Chan K-M, Lee W-C. A Six-Month, Prospective, Single-Center, Pilot Study to Determine the Pharmacokinetics and Effectiveness of Immunosuppressant Regimens in Liver Transplantation Patients Receiving Twice-Daily Tacrolimus and Everolimus (TAC + EVR BID) Regimen Converted to Once-Daily Tacrolimus and Everolimus (TAC + EVR QD) Regimen – A Priliminary Report [abstract]. https://atcmeetingabstracts.com/abstract/a-six-month-prospective-single-center-pilot-study-to-determine-the-pharmacokinetics-and-effectiveness-of-immunosuppressant-regimens-in-liver-transplantation-patients-receiving-twice-daily-tacrolimu/. Accessed June 1, 2025.« Back to 2018 American Transplant Congress