Korean J Transplant.  2022 Nov;36(Supple 1):S202. 10.4285/ATW2022.F-3363.

Effect of tacrolimus XL on variance coefficients in comparison with twice daily tacrolimus, and relationship with serum creatinine concentrations in kidney transplant recipients

• Mahadita GW
• Widiana IGR
• Putra IMR
• Wahyuningrum SA

• KMID: 2535267
• DOI: http://doi.org/10.4285/ATW2022.F-3363

Abstract

Background
Immunosuppressive therapy aims to prevent allograft rejection and minimize nephrotoxicity and infection. This study aims to determine the variance coefficient of plasma tacrolimus concentrations among kidney transplant recipients.
Methods
A comparative observational analytic with single group cross-over and a cross-sectional design was done at Transplant Outpatient Clinic General Hospital, RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar, Bali, Indonesia March 2019–August 2021. Nineteen kidney transplant recipients were assessed for tacrolimus therapy, blood tacrolimus, and serum creatinine. Tacrolimus treatment has two phases. First period immunosuppressive treatment was divided-dose tacrolimus. Second, tacrolimus XR was used as an immunosuppressant.
Results
There was significant difference between blood tacrolimus coefficient of variance (Co-V) of patients with XR tacrolimus and DD tacrolimus therapy (22.22%±7.39% vs. 44.32%±15.54%, P<0.001). There was significant linear correlation between blood tacrolimus Co-V and serum creatinine Co-V in all patients (r=0.74; RSQ=0.54; b=1.15; P<0.001). There was only significant linear correlation between blood tacrolimus Co-V in subgroup with DD tacrolimus therapy (r=0.58; RSQ=0.33; P=0.02) and none in patients with XR therapy (r=0.06; RSQ=0.004; P=0.84). In multivariate analysis with ANCOVA, it was shown that serum cre-atinine Co-V was associated with Co-V of blood tacrolimus (B=0.72; RSQ=0.255; P=0.01). Lower Co-V of tacrolimus and use of XR tacrolimus therapy is associated with lower Co-V of serum creatinine. On the other hand, XR treatment was associated with lower serum creatinine Co-V (B=–20.7; RSQ=0.20; P=0.02).
Conclusions
XR tacrolimus treatment reduces blood tacrolimus variation in renal transplant recipients. Blood tacrolimus con-centrations vary with serum creatinine, especially with divided-dose therapy. XR tacrolimus treatment reduces serum creati-nine variation.