Evaluation of immune function under conversion from Prograf to Advagraf in living donor liver transplantation
Takayuki Tanaka, Mitsuhisa Takatsuki, Akihiko Soyama, Yasuhiro Torashima, Ayaka Kinoshita, Izumi Yamaguchi, Tomohiko Adachi, Amane Kitasato, Tamotsu Kuroki, Susumu Eguchi
Ann Transplant 2013; 18:293-298
Although some reports have shown the safety and efficacy of conversion from Prograf to Advagraf in liver transplantation, there have been no reports showing the change of immune function after conversion. The aim of this study is not only to analyze the safety and efficacy of conversion from Prograf to Advagraf, but also to evaluate the immune function using the ImmuKnow assay.
Material and Methods: Of the 168 living donor liver transplantation (LDLT) patients, 21 recipients whose liver function was stable after discharge in outpatient clinic and who agreed to conversion from Prograf to Advagraf were enrolled in this study. Liver, renal, and immune functions were retrospectively reviewed.
Results: There were no significant differences in liver and renal function after conversion from Prograf to Advagraf. The intracellular adenosine triphosphate levels before and after conversion were 263±157 and 256±133 ng/ml, respectively, and there was also no significant difference in immune function. None of the recipients showed adverse effects, rejection, or severe infection during the study. It should be further noted that none of the recipients had to increase the dose of Advagraf, while five of 21 recipients (24%) were able to reduce the dose of Advagraf during this study.
Conclusions: Conversion from Prograf to Advagraf in LDLT can be performed safely and effectively without affecting liver, renal, and immune function.
Keywords: Advgraf, Tacrolimus, ImmuKnow, LDLT