Purpose: Pediatric patients are known to have lower compliance than adult patients. Once-daily formulation of tacrolimus may increase compliance in pediatric liver transplant recipients. The aim of this study was to evaluate the safety and feasibility of conversion from twice-daily tacrolimus to once-daily formulation.

Methods

Between June 1996 and Sep 2014, stable pediatric liver transplant recipients (n=118) with at least 1 year of post-transplant follow-up were selected. All patients were on twice-daily tacrolimus monotherapy. The switching policy was made on a 1mg:1mg basis (total daily dose) with a target trough level of 3-5 ng/mL.

Results

The mean age at conversion was 7.61 years(rage 1-24). Interval from LT to conversion timing was 5.7 ± 3.5 years. During a period of 6 months from conversion to once-daily formulation 103 patients (87.3%) maintained stable graft function. 14 patients (11.9%) had mild elevation (≥ 2-fold increase) of liver enzymes. One patient returned to twice-daily formulation because of biopsy-proven acute rejection (ACR 5/9) and was successfully managed with steroid pulse therapy.

Conclusion

Conversion from twice-daily to once-daily formulation of tacrolimus on a 1:1 daily dose basis was safe and effective in maintaining stable graft function in pediatric liver transplant recipients. Once-daily formulation of tacrolimus may be a useful option for pediatric liver transplant pediatric recipients with stable graft function.

CITATION INFORMATION: Lee N, Lee S, Cho C.-W, Lee J, Lee J, Kim J, Choi G.-S, Kwon C, Joh J.-W, Lee S.-K. Conversion to Once-Daily Tacrolimus in Stable Pediatric Liver Transplantation Recipients. Am J Transplant. 2016;16 (suppl 3).

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