Immunosuppression
Immunosuppressive therapy after LT was based on the combi­nation of calcineurin inhibitor (tacrolimus) and mycophenolate mofetil (MMF). Two types of twice-daily tacrolimus were used before the conversion: the ref­erence tacrolimus product (Prograf® ; Astellas Pharma, Tokyo, Japan) and the generic formulation of tacrolimus (Tacrobell® ; Chong Kun Dang Pharma, Seoul, Korea). All patients were converted to once-daily tacrolimus (Ad­vagraf® , Astellas Pharma, Inc., Deerfield, IL, USA) on a 1:1 mg basis for the total daily dose. However, some dose adjustments were permitted depending on the patient’s condition, and oth­er immunosuppressants were allowed to be used according to standard prac­tice. The serum trough levels of tacrolimus and clinical assessments for safety and rejection were completed four weeks after the conversion; then, parameters were evaluated routinely according to the patient’s follow-up schedule. The doses of tacrolimus at baseline and during fol­low-up were adjusted on an indi­vidual basis according to the serum trough level of the drug.