Experience of Tacrolimus Usage in Kidney Transplant Vietnamese Patients
Le Chi Cong¹, Nguyen Thi Thuy², Nguyen Duc Truong³, Bui Thi Hoai Thu⁴, Phan Anh Vu⁵, Bui Ba Nghe⁶, Nguyen Hai Nam⁷, Dong Thi Phuong Dung⁸, Tran Hue Anh⁹, Le Quang Loc⁸, Nguyen Duy Tung¹⁰, Nguyen Lam Vuong¹¹, Fatmaelzahraa yasser ali¹², Phu Tran Van¹³, Nguyen The Cuong¹, Nguyen Thanh Van⁸, Abdelrahman M Makram¹⁴,¹⁵, Nguyen Tien Huy¹⁶, Ha Phan Hai An¹⁷
Affiliation : ¹ Nephrology-Hemodialysis Department, University Medical Center of Ho Chi Minh City, Ho Chi Minh City, Vietnam; ² Department of Nephrology, Viet Duc Hospital, Vietnam; ³ Department of Obstetrics and Gynecology, FV Hospital, Ho Chi Minh City, Vietnam; ⁴ Bach Mai Hospital, Hanoi, Vietnam; ⁵ Emergency Department, Children’s Hospital 2, Ho Chi Minh City, Vietnam; ⁶ Faculty of Medicine, Vo Truong Toan University, Hau Giang, Vietnam; ⁷ Department of Liver Tumor, Cancer Center, Cho Ray Hospital, Ho Chi Minh City, Vietnam; ⁸ University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; ⁹ School of Medicine, International University of Health and Welfare, Japan; ¹⁰ Vietnam Military Medical University, Hanoi, Vietnam; ¹¹ Department of Medical Statistics and Informatics, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; ¹² Faculty of Medicine, Zagazig University, Zagazig, Egypt; ¹³ School of Medicine and Pharmacy, Tra Vinh University, Tra Vinh, Vietnam; ¹⁴ School of Public Health, Imperial College London, London, United Kingdom; ¹⁵ Faculty of Medicine, October 6 University, Giza, Egypt; ¹⁶ School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; ¹⁷ Department of Internal Medicine, Hanoi Medical University, Hanoi, Vietnam
Background: Tacrolimus (Tac) has been widely used with other immunosuppressive agents to prevent graft rejection post-kidney transplantation. However, the usage of Tac has depended on experience rather than evidence-based methods. In the present study, the authors investigated the Tac usage patterns and outcomes in kidney-transplanted patients at a transplant center located in the North of Vietnam.
Materials and Methods: A retrospective cross-sectional study was conducted. Patients were included if they underwent renal transplantation, received Tac as part of the immunosuppressive therapy, and had been followed up in Viet Duc Hospital during the period between February 2009 and February 2019. Excluded patients were those who did not use Tac or switched to another drug during treatment.
Results: The number of followed up patients steadily decreased from 342 cases in the first six months to 281 cases in the second year, 217 in the third year, 185 in the fourth year, and 152 in the fifth year post-transplanted. Only 17 cases had a ten-year follow-up. The number of transplants from deceased donors at 9.6% was much lower than live donors at 90.4%. Three patients died through the five years of the follow-up due to causes unrelated to kidney transplantation. Ten cases were ABO-incompatible transplantations. The mean blood concentration of Tac was highest in the first six months with 10.6 ng/mL, then gradually dropped to the lowest value at 6.3 ng/mL in the fifth year. Seven cases were identified as graft rejection with no clear outcome.
Conclusion: Although there were a lack of standard tests and facilities for taking care of kidney transplant patients, the intra-patient variability and Tac concentration of included patients in the author’s center were close to the international studies in developed countries in five years follow-up.
Received 19 December 2022 | Revised 8 July 2023 | Accepted 11 July 2023
DOI: 10.35755/jmedassocthai.2023.08.13878
Keywords : Tacrolimus; Transplantation; Kidney; Vietnam
All Articles
Download