ヌノダ シンイチ   SHINICHI NUNODA
  布田 伸一
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授
論文種別 症例報告
言語種別 英語
査読の有無 査読あり
表題 Switching to tacrolimus extended-release improved the effectiveness of immunosuppressive therapy in a heart transplant patient: A case report.
掲載誌名 正式名:Journal of cardiology cases
略  称:J Cardiol Cases
ISSNコード:18785409
掲載区分国内
出版社 Elsevier B. V. on behalf of the Japanese College of Cardiology
巻・号・頁 6(1),e26-e29頁
著者・共著者 NUNODA Shinichi†*, SUWA Kuniaki, SHITAKURA Kazunobu, KIKUCHI Tomoko, NAKAJIMA Shun, HATTAMMARU Miwa, MITSUHASHI Tetsuya, OKAJIMA Kiyotaka, KUBO Yutaka, OTSUKA Kuniaki
発行年月 2012/07
概要 We report on a 25-year-old female heart transplant patient who presented with recurrent episodes of cellular rejection due to decreased adherence to immunosuppressive therapy. She received a heart transplantation in 1994 when she was 10 years old. In order to improve her adherence to immunosuppressive therapy, switching to the once-daily extended-release formulation of tacrolimus was performed in a step-wise fashion. First, the twice-daily formulation of cyclosporin A was replaced with the twice-daily preparation of tacrolimus. When the trough blood levels of tacrolimus reached a plateau in the range of 5.0 ng/mL, it was changed to the once-daily extended-release formulation of tacrolimus after confirming the absence of new rejection episodes. There were no significant changes in renal function before and after the switch. After being discharged from the hospital, the patient made significant advancements in adherence to immunosuppressive therapy. Her subsequent clinical course was uneventful, with no adverse events observed. Most patients who undergo solid organ transplantation must receive lifelong immunosuppressive therapy. This case demonstrates that conversion to the extended-release formulation of tacrolimus from other calcineurin inhibitor preparations is a reasonable choice to consider in the management of compromised immunosuppressive therapy adherence in heart transplant patients during the late posttransplant period.
DOI 10.1016/j.jccase.2012.04.003
PMID 30532941