Publication:

Real-world utilization and acceptance of tacrolimus-based immunosuppression in solid organ transplant recipients in India

Background The objectives of the study were to describe the demographics and utilization pattern of tacrolimus (TAC)-based immunosuppressive regimens in recipients with solid organ transplant in India.

Methods This real-world, multicenter (134 centers), retrospective analysis included data of solid organ transplant recipients between 2010 and 2022 who had received TAC-based immunosuppressive therapy. The study data was collected between April 2021 and March 2022.

Results Data of a total of 1022 recipients with kidney transplant (KT, n=899) or liver transplant (LT, n=123) who received TAC-based immunosuppression was analyzed. The mean age of recipients among KT and LT was 41.04±10.62 and 42.88±11.32 years, respectively. The most common diseases leading to end stage organ failure were diabetes (24.7%), hypertension (15.8%), concomitant diabetes and hypertension (14.9%), chronic kidney disease (9.2%), nephrotic syndrome (5%), and end stage renal disease (ESRD, 4.4%) in KT recipients, whereas for LT, the common indications were liver cirrhosis (32.5%), hepatitis B viral infection (11.4%), alcoholic liver disease (10.6%), fatty liver disease (12, 9.8%) and non-alcoholic steatohepatitis (NASH, 5.7%). The source of transplant was living donor in majority of both KT (91.2%) and LT (77.2%) recipients. The most common induction regimen in KT was anti-thymocyte globulin (ATG), TAC, mycophenolate mofetil (MMF), and steroid (ATG+TAC+MMF+steroid, 42.3%) whereas in LT, it was TAC+MMF+steroid (67.5%); TAC+MMF+steroid was most common maintenance regimen (KT: 91.1%, LT: 78%).

Conclusions Tacrolimus-based immunosuppression is widely used in the recipients of solid organ transplantation, including KT or LT in real‑world clinical practice in India.