Article Text

PDF
DI-009 Clinical and economic assessment after changing basiliximab protocol in hepatic transplantation
  1. I Plasencia García1,
  2. E Tevar Alfonso1,
  3. A De León Gil1,
  4. A González2,
  5. A Moreno2,
  6. E Marqués Güell1,
  7. R Jurado Lopez1,
  8. MA Ocaña Gomez1,
  9. A Montero Delgado1,
  10. F Merino Alonso1
  1. 1Hospital Universitario Nuestra Señora de Candelaria, Farmacia, Santa Cruz de Tenerife, Spain
  2. 2Hospital Universitario Nuestra Señora de Candelaria, Digestivo, Santa Cruz de Tenerife, Spain

Abstract

Background Up until 2014, basiliximab was used in our hospital as an off-label prescription for hepatic transplantation in patients for whom starting tacrolimus had to be delayed because of their baseline characteristics. Dosage is two 20 mg perfusions (days 0 and +4 after transplantation). The second dose could be skipped if the patient has stable renal function. From 2014 onwards, all patients undergoing transplantation received the first dose in order to delay beginning tacrolimus and to reduce morbidity and hospitalisation time.

Purpose Clinical and economic assessment after the protocol change.

Material and methods Retrospective analysis of liver transplanted patients in 2013 vs. 2014 (new protocol), registering: age, sex, diagnosis, creatinine on ICU and hospital discharge, ICU stay, global stay, number of basiliximab doses administered, day beginning tacrolimus treatment after transplantation, and global and per patient economic cost.

Abstract DI-009 Table 1

ResultsBeginning tacrolimus was always day +1 when basiliximab was not administered and day +5 when two doses were administered. For patients receiving only one dose, in 2013 it was day +4.5 and in 2014 it was day +3.1. Creatinine on ICU discharge was significantly higher (1.11 vs 0.82, p < 0.05) in 2014, with no significant differences found for creatinine prior to transplantation, on hospital discharge or global or ICU stay. Vial consumption was 0.75/patient in 2013 and 1.5/patient in 2014, with a global cost difference of 31 301.37€.

Conclusion In our population, the protocol change did not show any clinical benefits in the parameters assessed (creatinine and ICU/hospital stay). Preliminary estimation of 50% of patients not receiving the second dose after the protocol change was fulfilled.

References and/or Acknowledgements

  1. Neuberger, et al. Delayed introduction of reduced-dose tacrolimus, and renal function in liver transplantation: the ‘ReSpECT’ study. Am J Transplant 2009.

References and/or AcknowledgementsNo conflict of interest.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.