Safety and Efficacy of Conversion from Conventional Twice Daily Tacrolimus to Once Daily Extended Release Tacrolimus in Stable Pancreas Transplant (SPK and PAK) Recipients
Surgery, Multi-Organ Transplant, Toronto General Hospital, Toronto, ON, Canada.
Meeting: 2015 American Transplant Congress
Abstract number: C194
Keywords: Calcineurin, Immunosuppression, Kidney/pancreas transplantation, Pancreas transplantation
Session Information
Session Name: Poster Session C: More Controversies in Pancreas Transplantation
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Background: A once-daily, modified-release oral formulation of tacrolimus has been developed to simplify dosing and improve medication adherence. There is limited data on the implementation and conversion to once-daily tacrolimus in Simultanous Pancreas-Kidney Transplant (SPK) and Pancreas After Kidney (PAK) recipients. We prospectively evaluated the safety and efficacy of a systematic switch from twice-daily tacrolimus to once-daily tacrolimus in stable pancreas transplant recipients.
Patients and Methods: From July 2013 to September 2014, 182 pancreas transplant recipients (SPK and PAK) that had been on stable immunosuppression for at least 6 months, were switched from Prograf® (twice-daily) to Advagraf® (once-daily). A 1:1.2 mg conversion was implemented to safely maintain FK trough levels. Demographics, tacrolimus trough levels, serum creatinine, estimated glomerular filtration rate (eGFR), glycohemoglobin (HbA1c) were prospectively collected before and 7 days, 3, 6 and 12 months post-conversion.
Results: Conversion from Prograf® to Advagraf® was performed in 136 SPK and 59 PAK recipients (Mean age 42.4 years, 65.1% male). Mean time from pancreas transplant to Advagraf conversion was 74.6 (+48.7) months and time of follow-up after conversion was 8 (+2.7) months. Mean Prograf® daily dose pre conversion was 5.1 (+2.9) mg and mean Advagraf® dose at conversion and at last follow up was 6.0 (+3.0) and 6.0 (+3.3) mg, respectively. FK trough levels were 8.7, 9.0, 8.0, 7.7 and 6.2 at pre-conversion, 7-days, 3-months, 6-months and 1-year post-conversion. Similarly, HbA1c were 5.4, 5.7, 5.3, 5.3, 5.3 % and eGFR were 51.0, 49.2, 50.8, 52.1, 48.5 mL/min/1.73 m2 at pre-conversion, 7-days, 3-months, 6-months and 1-year post-conversion. There were 4 (2.0%) episodes of rejection post-conversion. Average time from conversion to rejection was 5.5 (+0.9) months.
Conclusions: This is the largest report of pancreas transplant recipient outcomes after conversion to Tacrolimus once-daily. This regimen implementation is safe and effective, showing short-term stable glucose control and glomerular filtration rate, for recipients on stable immunosuppression after Simultaneous Pancreas/Kidney Transplant or Pancreas After Kidney Transplant.
To cite this abstract in AMA style:
Dib M, Barbas A, Marquez M, Laurence J, Sapisochin G, Norgate A, Schiff J, McGilvray I, Greig P, Selzner M, Cattral M. Safety and Efficacy of Conversion from Conventional Twice Daily Tacrolimus to Once Daily Extended Release Tacrolimus in Stable Pancreas Transplant (SPK and PAK) Recipients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/safety-and-efficacy-of-conversion-from-conventional-twice-daily-tacrolimus-to-once-daily-extended-release-tacrolimus-in-stable-pancreas-transplant-spk-and-pak-recipients/. Accessed May 8, 2025.« Back to 2015 American Transplant Congress