Böbrek nakli hastalarında de novo uzatılmış salımlı takrolimus; Güvenli mi?

Year 2023, , 478 - 483, 30.09.2023

Mahmud İslam , Necattin Fırat , Musa Pınar , Kenan Evren Öztop , Gözde Çakırsoy Çakar , Zafer Ercan , Enes Sarıgedik , Hamad Dheir

https://doi.org/10.31832/smj.1326320

Abstract

Amaç: Bu çalışma, de novo uzatılmış salımlı takrolimus (UST) tedavisinin böbrek alıcılarında güvenli olup olmadığını araştırmayı amaçladık.
Yöntem ve gereçler: Çalışmamız tek merkezli, retrospektif olup, UST grubundan 30 hasta (Grup 1) ve hılzı salımlı takrolimus (HST) grubundan 27 hasta (Grup 2) olmak üzere toplam 57 hastayı içermektedir. Hastaların demografik ve laboratuvar özellikleri kaydedildi. Akut ilaç toksisitesi, akut rejeksiyon, transplantasyon sonrası yeni başlayan diabetes mellitus, hipertansiyon gelişmesi, fırsatçı enfeksiyon ve hastaneye yatış verileri ve diğer olası komplikasyonlar kaydedildi.
Bulgular: Hastaların yaş ortalaması UST grubunda 46,23±14,2 yıl iken HST grubunda 47,04±14,6 yıl idi. Grup 1'de 21 (%70), grup 2'de 20 (%74) hasta erkek idi (P>0,05). Postoperatif 1. haftada serum kreatinin değerlerinde düzelme oranı her iki grupta da benzerdi. Postoperatif 1. gün ortalama takrolimus seviyeleri grup-1'de anlamlı olarak düşük iken (P<0.05), postoperatif 2-7. günlerde takrolimus seviyeleri arasında anlamlı fark yoktu. İlk altı aylık izlemde fırsatçı enfeksiyonlar, diabetes mellitus ve hastaneye yatış ihtiyacı açısından gruplar arasında anlamlı fark yoktu.
Sonuç: Böbrek alıcılarında de novo uzatılmış salımlı takrolimus tedavisinin başlatılması uzun vadede güvenlidir ve greft fonksiyonunu korur.

Keywords

Böbrek nakli, uzatılmış salımlı takrolimus, hızlı salımlı takrolimus, greft fonksiyonu.

De novo extended-release Tacrolimus in Kidney Transplant Patients; Is it safe?

Abstract

Background: This study aimed to investigate whether de novo extended-release tacrolimus (ERT) therapy is safe in kidney recipients.
Methods: The study was single-center, retrospective, and included a total of 57 patients, including 30 patients in the ERT group (Group 1) and 27 patients in the immediate-release tacrolimus (IRT) group (Group 2). Demographic and laboratory characteristics of the patients were recorded. Complications such as acute drug toxicity, acute rejection, new-onset diabetes mellitus after transplantation, and development of hypertension, opportunistic infection, and hospitalization data were recorded.
Results: The mean age of the patients was 46.23±14.2 years in the ERT group and 47.04±14.6 years in the IRT group. There were 21 (70%) males in group 1, while 20 (74%) patients in group 2 had a male gender (P=0.73). The rate of improved serum creatinine values in the first week postoperatively was similar in both groups. While the mean tacrolimus levels on postoperative day 1 were significantly lower in the group- 1 (P<0.05), there was no significant difference between tacrolimus levels on postoperative days 2-7. There was no significant difference between the groups regarding opportunistic infections, diabetes mellitus, and the need for hospitalization in the first six months of follow-up.
Conclusion: Initiation of de novo extended-release tacrolimus therapy in kidney recipients is safe in the long term and preserves graft function.

Keywords

Kidney transplantation, extended-release tacrolimus, immediate-release tacrolimus

Thanks

We would thank Dr. Fehmi Celebi, Dr. Fatih Altintoprak and Dr. Emrah Akin for their logistic support and help in our study.

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