Background: Hepatoprotective agent Schisandra sphenanthera extract (SchE) facilitates rifampicin-containing anti-tuberculosis (TB) chemotherapy by stabilizing the Tacrolimus (FK506) blood concentration through increasing the oral bioavailability, which indicates that SchE would be a potential FK506-sparing agent during post-transplant TB treatment.

Method: the FK506-sparing effect of SchE during anti-TB chemotherapy containing rifampicin in 22 documented post-transplant TB cases in Southern China transplantation center between 2004 and 2010 were enrolled and analyzed.

Results: Before coadministration of SchE, the average dosage of FK506 before-TB, treated without SchE, treated with SchE is 0.048±0.030 mg/kg/day, 0.079±0.037 mg/kg/day, 0.063±0.038 mg/kg/day. Meanwhile, corrected blood concentration of FK506 is 109.2±34.8 ng/ (ml.mg.kg), 45±22.9 ng/ (ml.mg.kg), 93.9±38.6 ng/ (ml.mg.kg) respectively. Till now, 16 cases of TB patients have been successfully cured and six cases still under treatment. Seven patients had hyperuricemia (31.8%), three cases (13.65) had the liver function damage while one case complicated with peripheral neuropathy (4.5%). No acute rejection developed among the study population.

Conclusion: SchE acts as an effective FK506 sparing agent which greatly reduced the dose required to reach therapeutic blood concentration when coadministration of rifampicin, and greatly decreased the risk of acute rejection, which make rifampicin-containing anti-TB chemotherapy possible and safe.

CITATION INFORMATION: Deng R, Zhang L, Liu L, Fu H, Li J, Fu Q, Wang C. Schisandra Sphenanthera Extract Facilitates Anti-Tuberculosis Treatment Post Renal Transplantation Through Increasing Bioavailability of Tacrolimus. Am J Transplant. 2016;16 (suppl 3).

« Back to 2016 American Transplant Congress