Conversion to LCP Tacrolimus Mitigates Calcineurin‐Induced Nephrotoxicity in Patients After Liver Transplantation
Maximilian Joseph Brol, Isabella Munske, Iyad Kabar, Philipp Stephan Althaus, Wenyi Gu, Frank Erhard Uschner, Michael Praktiknjo, Martin Sebastian McCoy, Kai‐Henrik Peiffer, Florian Rennebaum, Philipp Houben, Andreas Pascher, Hartmut H Schmidt, Jonel Trebicka, Tina Schomacher, Anna Hüsing‐KabarABSTRACT
Background
Calcineurin inhibitor (CNI)‐induced nephrotoxicity after liver transplantation (LT) is linked to increased morbidity and mortality. LCPT offers a particular extended‐release formulation, potentially improving the concentration‐dose (C/D) ratio and renal outcomes. This study investigated the impact of switching from standard‐release Tacrolimus (SR‐Tac) to LCPT on C/D ratio and renal function.
Methods
170 adult LT recipients (August 2008–March 2020) treated with tacrolimus for at least two years were included. In this single‐center, retrospective analysis, 63 patients converted to LCPT, while 107 patients continued on SR‐Tac. Clinical data were collected every three months over 24 months.
Results
At baseline, median C/D ratios were similar between groups ( p = 0.553), the LCPT group showed significantly higher C/D ratios compared to SR‐Tac during both the first ( p = 0.003) and second year ( p = 0.004). While LCPT‐treated patients showed an increased mean estimated glomerular filtration rate (eGFR), the SR‐Tac group exhibited a progressive decline at each follow‐up (mean decline: −5.4 mL/min/1.73m 2 at 24 months, p <0.001). Logistic regression identified switch to LCPT ( p <0.001), female sex ( p = 0.043), and baseline eGFR ( p = 0.038) as significant predictors of eGFR change.
Conclusion
Conversion to LCPT may improve renal function in LT recipients over two years, suggesting potential long‐term nephroprotection without compromising graft function.