Low Dose Tacrolimus Strategy On Long-term Survival Patients With Liver Transplantation For Benign Disease:Evaluation And Analysis

Background:The application of immunosuppressantsmakes long-term survival rate of liver transplantation, particularly liver transplantation for benign diseases increase. But the long-term use of immunosuppressive drugs, especially calmodulin inhibitors after liver transplantation make incidence and mortality rates of renal dysfunction, neonatal diabetes, tumors, infection increase. The current study of Calmodulin inhibitors minimize, though delaying use, replacement or reduction, removal and other means, to reduce its side effects. But to long-term survival in patients,long-term immunosuppressive regimen has seldom research.Methods:This research studies on112cases of long-term survived patients with liver transplantion for benign diseas,with monitoring TAC concentration and related indicators. Whether TAC concentration below3ng/ml is divided into low concentration group or standard concentration group, whether TAC concentration below5ng/ml and the following in3years is divided into early group and late group.Through statistics compared, all above groups are analysised with incidence of rejection, and long-term complications and forecast factors.Results:Both Tacrolimus concentration below3ng/ml and below5ng/ml within3years do not increase the incidence of rejection. Stabilized below5ng/ml within3years after surgery can reduce the recurrence of hepatitis B, hepatitis B infection after liver transplantation, neonatal diabetes (P<0.05). Concentration of Tacrolimus on6month after surgery, preoperative liver function (ALT, AST) are predictors of stability less than3ng/ml postoperative.Conclusion:We recommend tacrolimus concentration is lower than5ng/ml as soon as possible after surgery, and that a final concentration of tacrolimus concentration is less than3ng/ml.This Low dose Tacrolimus strategy on long-term survival patients with liver transplantation for benign disease is safe and feasible, and will decrease the incidence of long-term complications, improve the long-term quality of life of patients.