BACKGROUND: @entity1140 once-daily formulation (TacOD) was introduced as an alternative to twice-daily formulations de novo. Dosing recommendations range between 0.1 to 0.2 mg/kg @entity63903 . MATERIAL AND METHODS: Amended dosing with a simple bottom-up de novo algorithm is presented. Primary outcome measure was feasibility of establishing adequate target trough levels and avoidance of over-immunosuppression, with adequate safety and efficacy after liver transplantation (LT). RESULTS: TacOD was given to 101 @entity1 . Standard steroid-free immunosuppression consisted of MMF 2 g/ @entity63903 , basiliximab 20 mg on day 0 and 4, and delayed bottom-up IS with TacOD starting with 1 mg/ @entity63903 and doubling the dosage every day until target trough levels of 5 to 8 ng/ml were reached. By day 7 after LT, all except 3 @entity1 had received TacOD. The earliest time point of introduction was day 2. A median of 9 mg/ @entity63903 (range: 0 to 25 mg/ @entity63903 ) of TacOD were necessary to establish the trough levels by day 10, which was then 5.4 ng/ml (range: 1.5 to 20 ng/ml). Incidence of adverse events (AE), in particular @entity16 (n=3), were low. Efficacy failure (acute rejection) was low (4.9%). Renal function was stable and did not deteriorate under CNI treatment. CONCLUSIONS: This is the first report of bottom-up, amended, and simple dosing of TacOD in LT. The algorithm is feasible, safe, and efficient, avoiding trough level peaks and top-down strategies.

Delayed bottom-up and amended simple method of dosing with once-daily XXXX application to achieve stable trough levels in liver transplantation.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity63903 :: ('55234', 'Gene') :: ['BW/d', 'd'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological AEs'] @entity1140 :: ('MESH:D016559', 'Chemical') :: ['Tacrolimus']
@entity1140 :: (MESH:D016559,Chemical) :: ['tacrolimus']
