Higher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection.

Hdl Handle:
http://hdl.handle.net/10147/127487
Title:
Higher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection.
Authors:
O'Seaghdha, C M; McQuillan, R; Moran, A M; Lavin, P; Dorman, A; O'Kelly, P; Mohan, D M; Little, P; Hickey, D P; Conlon, P J
Affiliation:
Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
Citation:
Higher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection., 23 (4):462-8 Clin Transplant
Journal:
Clinical transplantation
Issue Date:
6-Apr-2011
URI:
http://hdl.handle.net/10147/127487
DOI:
10.1111/j.1399-0012.2009.01021.x
PubMed ID:
19681975
Abstract:
We analyzed the association between whole-blood trough tacrolimus (TAC) levels in the first days post-kidney transplant and acute cellular rejection (ACR) rates. Four hundred and sixty-four consecutive, deceased-donor kidney transplant recipients were included. All were treated with a combination of TAC, mycophenolate mofetil and prednisolone. Patients were analyzed in four groups based on quartiles of the mean TAC on days 2 and 5 post-transplant: Group 1: median TAC 11 ng/mL (n = 122, range 2-13.5 ng/mL), Group 2: median 17 ng/mL (n = 123, range 14-20 ng/mL), Group 3: median 24 ng/mL (n = 108, range 20.5-27 ng/mL) and Group 4: median 33.5 ng/mL (n = 116, range 27.5-77.5 ng/mL). A graded reduction in the rates of ACR was observed for each incremental days 2-5 TAC. The one-yr ACR rate was 24.03% (95% CI 17.26-32.88), 22.20% (95% CI 15.78-30.70), 13.41% (95% CI 8.15-21.63) and 8.69% (95% CI 4.77-15.55) for Groups 1-4, respectively (p = 0.003). This study suggests that higher early TACs are associated with reduced rates of ACR at one yr.
Item Type:
Article
Language:
en
MeSH:
Adolescent; Adult; Aged; Cadaver; Child; Child, Preschool; Drug Monitoring; Drug Therapy, Combination; Female; Graft Rejection; Graft Survival; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Middle Aged; Mycophenolic Acid; Prednisolone; Retrospective Studies; Tacrolimus; Young Adult
ISSN:
1399-0012

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Seaghdha, C Men
dc.contributor.authorMcQuillan, Ren
dc.contributor.authorMoran, A Men
dc.contributor.authorLavin, Pen
dc.contributor.authorDorman, Aen
dc.contributor.authorO'Kelly, Pen
dc.contributor.authorMohan, D Men
dc.contributor.authorLittle, Pen
dc.contributor.authorHickey, D Pen
dc.contributor.authorConlon, P Jen
dc.date.accessioned2011-04-06T14:17:52Z-
dc.date.available2011-04-06T14:17:52Z-
dc.date.issued2011-04-06T14:17:52Z-
dc.identifier.citationHigher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection., 23 (4):462-8 Clin Transplanten
dc.identifier.issn1399-0012-
dc.identifier.pmid19681975-
dc.identifier.doi10.1111/j.1399-0012.2009.01021.x-
dc.identifier.urihttp://hdl.handle.net/10147/127487-
dc.description.abstractWe analyzed the association between whole-blood trough tacrolimus (TAC) levels in the first days post-kidney transplant and acute cellular rejection (ACR) rates. Four hundred and sixty-four consecutive, deceased-donor kidney transplant recipients were included. All were treated with a combination of TAC, mycophenolate mofetil and prednisolone. Patients were analyzed in four groups based on quartiles of the mean TAC on days 2 and 5 post-transplant: Group 1: median TAC 11 ng/mL (n = 122, range 2-13.5 ng/mL), Group 2: median 17 ng/mL (n = 123, range 14-20 ng/mL), Group 3: median 24 ng/mL (n = 108, range 20.5-27 ng/mL) and Group 4: median 33.5 ng/mL (n = 116, range 27.5-77.5 ng/mL). A graded reduction in the rates of ACR was observed for each incremental days 2-5 TAC. The one-yr ACR rate was 24.03% (95% CI 17.26-32.88), 22.20% (95% CI 15.78-30.70), 13.41% (95% CI 8.15-21.63) and 8.69% (95% CI 4.77-15.55) for Groups 1-4, respectively (p = 0.003). This study suggests that higher early TACs are associated with reduced rates of ACR at one yr.-
dc.language.isoenen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshCadaver-
dc.subject.meshChild-
dc.subject.meshChild, Preschool-
dc.subject.meshDrug Monitoring-
dc.subject.meshDrug Therapy, Combination-
dc.subject.meshFemale-
dc.subject.meshGraft Rejection-
dc.subject.meshGraft Survival-
dc.subject.meshHumans-
dc.subject.meshImmunosuppressive Agents-
dc.subject.meshKidney Transplantation-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshMycophenolic Acid-
dc.subject.meshPrednisolone-
dc.subject.meshRetrospective Studies-
dc.subject.meshTacrolimus-
dc.subject.meshYoung Adult-
dc.titleHigher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection.en
dc.typeArticleen
dc.contributor.departmentDepartment of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.en
dc.identifier.journalClinical transplantationen
dc.description.provinceLeinster-

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