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Impact of Changing Tacrolimus Formulation on Cerebral Blood Flow and Cognitive Function

I. Mahaparn, R. Lepping, R. N. Montgomery, R. Mukherjee, S. Billinger, W. M. Brooks, A. Gupta

University of Kansas Medical Center (KUMC), Kansas City, KS

Meeting: 2022 American Transplant Congress

Abstract number: 1287

Keywords: Immunosuppression, Magnetic resonance imaging, Neurotoxicity, Vascular disease

Topic: Basic Science » Basic Science » 12 - Immunosuppression & Tolerance: Preclinical & Translational Studies

Session Information

Session Name: Immunosuppression & Tolerance: Preclinical & Translational Studies

Session Type: Poster Abstract

Date: Monday, June 6, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: To assess if switching to extended release (ER) tacrolimus changes cerebral blood flow (CBF) or cognitive function after switching stable kidney transplant (KT) recipients from immediate release (IR) tacrolimus to ER tacrolimus.

*Methods: We randomized (2:1) KT recipients on IR tacrolimus either to the ER tacrolimus or control groups (who continued immediate release tacrolimus). All participants underwent brain MRI and transcranial doppler (TCD) exam (to assess CBF) and neuropsychological testing (to assess cognitive function) at baseline (prior to randomization) and in 12 weeks.

*Results: Participants were 51±13 years old and 60% male. Tacrolimus levels at baseline and at 12 weeks were similar in the 2 groups. There was no difference in change in CBF in any of the 14 pre-specified areas of the brain assessed with brain MRI or TCD in the two groups. Similarly, there was no difference in 12 of the total 14 neurophysiological tests performed. Digit span (p = 0.005) and Block design (p=0.05) improved in the control group. The primary outcomes are presented in Table 1.

*Conclusions: In this pilot study, switching from IR tacrolimus to ER tacrolimus did not alter CBF or cognitive function. Within the therapeutic range of tacrolimus, the tacrolimus formulation may not impact CBF or cognitive function.

Comparison of change in primary outcomes between groups (Mean (SD))
Table 1 Intervention (n=17) Control (n=8) p-value
Gray Matter CBF ml/min/100g tissue 0.00 (9.17) -7.15 (11.4) 0.17
Trailmaking A (sec) -3.11 (5.70) -2.44 (5.05) 0.50
Trailmaking B (sec) -8.84 (24.6) -2.67 (14.3) 0.83
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To cite this abstract in AMA style:

Mahaparn I, Lepping R, Montgomery RN, Mukherjee R, Billinger S, Brooks WM, Gupta A. Impact of Changing Tacrolimus Formulation on Cerebral Blood Flow and Cognitive Function [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-changing-tacrolimus-formulation-on-cerebral-blood-flow-and-cognitive-function/. Accessed May 18, 2025.

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