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Abstract: TH-PO1113

Graft Function and Other Outcomes in Kidney Transplant Recipients Converting from Immediate-Release to Prolonged-Release Tacrolimus

Session Information

  • Late-Breaking Posters
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

  • 2102 Transplantation: Clinical


  • Krämer, Bernhard K., University Hospital, Mannheim, Germany
  • Kamar, Nassim, Toulouse University, Toulouse, France
  • Kóbori, László, Semmelweis University, Budapest, Hungary
  • Lemoine, Mathilde, Hopital Charles Nicolle, Rouen, France
  • Nemes, Balazs, University of Debrecen, Debrecen, Hungary
  • Lee, Su Hyung, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea (the Republic of)
  • Ha, Hai An Phan, Viet Duc University Hospital, Hanoi, Viet Nam
  • Watarai, Yoshihiko, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
  • Yang, Jaeseok, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
  • Kuypers, Dirk R., University Hospitals Leuven, Leuven, Belgium
  • Blogg, Martin, Astellas Pharma Europe, Ltd., Addlestone, United Kingdom
  • Harkavyi, Alexander, Astellas Pharma Europe, Ltd., Addlestone, United Kingdom
  • Repetur, Carola, Astellas Pharma Europe, Ltd., Addlestone, United Kingdom
  • Scrine, Ludmila, Astellas Pharma Europe, Ltd., Addlestone, United Kingdom
  • Soliman, Mohamed, Astellas Pharma Singapore Pte Ltd., Singapore, Singapore

CHORUS (NCT02555787) was a long-term, prospective, global, non-interventional study investigating clinical outcomes in kidney transplant recipients (KTRs) converted from twice-daily, immediate-release tacrolimus to once-daily, prolonged-release tacrolimus (PRT; Advagraf®, Astellas Pharma Europe, Ltd.) under standard practice conditions.


This study enrolled KTRs (≥18 years, N=4389) who converted to PRT based on the judgment of their treating physician. Based on the post-transplant time of conversion, KTRs were grouped into early converters (ECs; ≤6 months) or late converters (LCs; >6 months). The primary endpoint was the change in renal function (measured by estimated glomerular filtration rate, eGFR) from conversion up to 5 years; secondary endpoints included graft survival (GS). GS was also assessed using subgroup variables: converters after <3 vs ≥3 years of transplant; no changes vs changes in immunosuppressive (IS) regimen (other than PRT); coefficient of variation (CV) for tacrolimus levels <35% vs ≥35%


The full analysis set included 4028 KTRs (ECs, 1060; LCs, 2968). Mean eGFR at conversion was 56.1 mL/min/1.73m2; it remained stable post-conversion in the overall and LCs, with improvements in the ECs over 5 years. Kaplan-Meier estimate of 5-year GS was 95.0% (ECs, 88.1%; LCs, 97.3%). GS was higher in KTRs with no changes vs KTRs with changes in IS regimen. GS was similar in KTRs in <35% and ≥35% tacrolimus CV subgroups. GS was higher in converters after ≥3 years vs <3 years of transplant. GS was higher in LCs vs ECs across all subgroups (Table).


Results from this large cohort of KTRs showed overall stable renal function. Graft survival was high 5 years post-transplant, supporting the long-term use of PRT. In addition, some KTR subgroups (IS regimen changes, ECs with ≥35% CV, converters after <3 years) may benefit from closer monitoring.