Abstract:

Objective To explore the clinical application value of extended release tacrolimus in longterm adult liver transplantation recipients with stable liver function. Methods The clinical data of long-termliver transplant recipients who were followed up in our hospital from January 2018 to January 2023 and converted to extended release tacrolimus were reviewed. The changes of liver function，renal function，tacrolimus drug concentration and CD4+ T cell count at different time points before and after the application of extended release tacrolimus were analyzed. Results A total of 21 patients were treated with extended release tacrolimus after liver transplantation. The male to female ratio was 13 ∶ 8. The average age was（60.07±8.24）years old. The conversion time（from liver transplantation surgery）was（28.85±49.47）months. The dose ratio of immediate- and extendedrelease tacrolimus was 1 ∶ 1.03. Compared with that before conversion，the levels of alanine aminotransferase （ALT），aspartate aminotransferase（AST），γ-glutamyl transpeptadase（GGT），alkaline phosphatase（ALP）， creatinine（Cre），bloodureanitrogen（BUN），as well as the number of CD4+ T cells and tacrolimus concentration were not statistically significant in 2，4，12 weeks after dressing change. Three patients showed slight fluctuations in liver function，and liver function returned to normal after adding extended release tacrolimus. Conclusion The adult liver transplantation patients with stable liver function were changed from immediate tacrolimus to extended release tacrolimus，the liver function was stable and the rejection rate was low，the renal function was not significantly improved. 

Key words:

Liver transplantation, Extended release tacrolimus, Adult

摘要：

目的 探讨他克莫司缓释胶囊在肝功能稳定的远期成人肝移植受者中的临床应用价值。方法 回顾 2018 年 1 月至 2023 年 1 月北京清华长庚医院随访的远期肝移植受者转换为他克莫司缓释胶囊的临床资料，分析应用他克莫司缓释胶囊前、后不同时间点肝功能、肾功能、他克莫司药物浓度、CD4+ T 细胞数量变化趋势。结果 肝移植术后应用他克莫司缓释胶囊患者共 21 例，男性女性比为 13 ∶ 8。平均年龄为（60.07±8.24）岁。转换时间（距肝移植手术）为（28.85±49.47）个月。他克莫司普通剂型与缓释剂型剂量比为 1 ∶ 1.03。与转换前相比，换药后 2、4、12 周丙氨酸转氨酶（alanine aminotransferase，ALT）、天冬氨酸转氨酶（aspartate aminotransferase，AST）、γ- 谷氨酰转移酶（γ-glutamyl transpeptadase，GGT）、碱性磷酸酶（alkaline phosphatase，ALP）、肌酐（creatinine，Cre）、尿素氮（bloodureanitrogen，BUN）、CD4 + T 细胞数量及他克莫司浓度相比无统计学意义。3 例患者出现肝功能轻微波动，增加他克莫司缓释胶囊剂量后肝功能恢复正常。结论 肝功能稳定的远期成人肝移植患者由他克莫司普通剂型等比例转换为他克莫司缓释剂型后，肝功能稳定，排斥反应发生率低，肾功能改善不明显。 

关键词:

肝移植 , 他克莫司缓释胶囊 , 成人