Impact of converting adult kidney transplant recipients with high tacrolimus variability from twice daily immediate release tacrolimus to once daily LCP‐Tacrolimus

• DOI: 10.1111/ctr.14941
• Publication Date: 2023-02-21T17:57:04Z
• Authors: David J. Taber; Felicia Bartlett; Neha Patel; Taylor Sprague; Shikha Patel; Jessica Newman; Erika Andrade; Nikhil Rao; Maria Aurora Posa...; Michael Casey; Derek Dubay; Vinayak Rohan
• Keywords: Coefficient of variation; Single Center

Abstract Background The influence of converting to once daily, extended‐release LCP‐Tacrolimus (Tac) for those with high tacrolimus variability in kidney transplant recipients (KTRs) is not well‐studied. Methods Single‐center, retrospective cohort study adult KTRs converted from Tac immediate release LCP‐Tac 1‐2 years post‐transplant. Primary measures were variability, using the coefficient variation (CV) and time therapeutic range (TTR), as well clinical outcomes (rejection, infections, graft loss, death). Results A total 193 included a follow‐up 3.2 ± .7 1.3 .3 since conversion. Mean age was 52 13 years; 70% African American, 39% female, 16% living donor 12% after cardiac death (DCD). In overall cohort, tac CV 29.5% before conversion, which increased 33.4% ( p = .008). >30% n 86), conversion reduced (40.6% vs. 35.5%; .019) nonadherence or med errors 16), substantially (43.4% 29.9%; .026). TTR significantly improved (52.4% 82.8%; .027) without (64.8% 73.2%; .005). CMV, BK, infections higher prior 3% had rejection 2% NS). At end follow‐up, patient survival 94% 96%, respectively. Conclusions CV, associated significant reduction improvement TTR, particularly medication errors.