Experiences on conversion to once-daily Advagraf and sirolimus combination in stable kidney recipients

In transplant recipients, nephrotoxicity due to long-term use of calcineurin inhibitor (CNI) is a serious problem that cannot be overlooked. Medication compliance can cause graft failure in transplant recipients who are bound to long-term medication. In this study, 36 patients who underwent conversion to once-daily Advagraft and sirolimus combination at Korea University Anam Hospital from September 2011 to March 2013 were retrospectively reviewed at 3 and 6 months for laboratory findings, mean arterial pressure (MAP), and so on. After conversion, serum creatinine level and glomerular filtration rate (GFR) decreased significantly at 3 months (P = .024 and P < .001, respectively). Fasting serum glucose level and proteinuria increased significantly at 6 months (P = .016 and P = .030, respectively). The impact of time after conversion at 3 months was significantly related to the increase in postoperative estimated glomerular filtration rate (eGFR). Graft rejection, morbidity, and mortality did not occur within the study period. A once-daily Advagraf and sirolimus regimen can be a novel standard regimen in stable kidney recipients due to its effects in improving renal function and convenience for patients.