Pediatric transplantation · 2026
Tacrolimus variability and medication adherence pre- and post-conversion from immediate-release to extended-release tacrolimus in pediatric solid organ transplant.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bitterfeld Leandra, Jackson Rachel L, Sanchez-Garcia Jorge, Bucher Bridget, Brewer Ashlie, Heyrend Caroline
Аннотация
BACKGROUND: Adolescents receiving solid organ transplants (SOT) are at increased risk for rejection and graft loss, driven by suboptimal immunosuppressive medication adherence. This study evaluated the effect of conversion from immediate-release tacrolimus (IR-Tac) to extended-release tacrolimus (LCPT) on medication adherence in pediatric SOT recipients.
METHODS: We conducted a retrospective, observational single-center study of heart, liver, and kidney transplant recipients who converted from IR-Tac to LCPT. Medication adherence was measured as tacrolimus standard deviation (tac-SD), with tac-SD > 2 considered the threshold for poor adherence, and self-reported adherence during the one year before and after conversion.
RESULTS: Fifty-four pediatric SOT recipients were included, with a median age of 9 years at transplant and 14.4 years at conversion from IR-Tac to LCPT. Among the entire cohort, overall tac-SD did not differ before and after conversion. Among children with high baseline variability (tac-SD > 2), tac-SD significantly decreased from a median of 3.0 to 2.7 (p = 0.014), whereas children with low baseline variability (tac-SD < 2) experienced a significant increase in tac-SD from 1.3 to 2.2 (p < 0.001). The proportion of children reporting missed doses more than once a week decreased from 13 (24%) to 7 (13%; p = 0.07). There was no change in tac-SD between children who were and were not converted to LCPT for an adherence concern.
CONCLUSION: Tac-SD decreased after conversion from IR-Tac to LCPT among those with high baseline variability but increased among those with low baseline variability; there were no significant changes in subjective adherence measures. The effectiveness of conversion from IR-Tac to LCPT for adherence is unclear.
METHODS: We conducted a retrospective, observational single-center study of heart, liver, and kidney transplant recipients who converted from IR-Tac to LCPT. Medication adherence was measured as tacrolimus standard deviation (tac-SD), with tac-SD > 2 considered the threshold for poor adherence, and self-reported adherence during the one year before and after conversion.
RESULTS: Fifty-four pediatric SOT recipients were included, with a median age of 9 years at transplant and 14.4 years at conversion from IR-Tac to LCPT. Among the entire cohort, overall tac-SD did not differ before and after conversion. Among children with high baseline variability (tac-SD > 2), tac-SD significantly decreased from a median of 3.0 to 2.7 (p = 0.014), whereas children with low baseline variability (tac-SD < 2) experienced a significant increase in tac-SD from 1.3 to 2.2 (p < 0.001). The proportion of children reporting missed doses more than once a week decreased from 13 (24%) to 7 (13%; p = 0.07). There was no change in tac-SD between children who were and were not converted to LCPT for an adherence concern.
CONCLUSION: Tac-SD decreased after conversion from IR-Tac to LCPT among those with high baseline variability but increased among those with low baseline variability; there were no significant changes in subjective adherence measures. The effectiveness of conversion from IR-Tac to LCPT for adherence is unclear.