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논문분류	춘계학술대회 초록집
제목	Minimal tacrolimus maintenance dosage with conventional use of enteric coated mycophenolate sodium for stable kidney transplant recipients: A randomized controlled trial.
저자	Sehoon PARK1, Yon su KIM1, Jungpyo LEE3, Wooseong HUH4, Chul woo YANG5, Young-lim KIM6, Yeong hoon KIM7, Joong kyung KIM8, Chang-kwon OH9, *Sukil PARK2
출판정보	2017; 2017(1):
키워드	Kidney transplantation, tacrolimus, mycophenolate sodium, rejection
초록	Objectives : Minimizing tacrolimus dosage in patients with stable allograft function needs further evidence. Methods : We performed an open-label randomized controlled study, from 2010 to 2016 in 7 tertiary teaching hospitals in Korea with 345 kidney transplant recipients who maintained stable graft status. The study group received reduced dose tacrolimus, 1,080-1,440 mg/day of enteric coated mycophenolate sodium (EC-MPS) and corticosteroid. The control group had standard tacrolimus dosage and 540-720 mg/day of EC-MPS with steroid. The primary endpoint was mean estimated glomerular filtration rate (eGFR) and eGFR change at the end of the study, 12 months after randomization. Results : As a result, mean tacrolimus trough level of the study group was about 4.51±1.62 ng/mL, which was lower than that of the control group, 6.75±2.82 ng/mL (P<0.001). The primary endpoint was better in the study group in terms of eGFR change (P<0.001). The month 12 eGFR was 73.6±28.4 and 68.3±18.1 mL/min/1.73m2 in the study and the control group, respectively, but the difference did not reach level of statistical significance (P=0.066). Incidence of adverse events was similar and there was no graft loss. Conclusions : Therefore, minimizing tacrolimus level up to 4.5 ng/mL, combined with conventional EC-MPS, could be considered in patients on steady followup without increasing rejection risk.
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