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J Nephrol. 2016 Apr;29(2):269-276. doi: 10.1007/s40620-015-0230-0. Epub 2015 Sep 15.

Tacrolimus trough-level variability predicts long-term allograft survival following kidney transplantation.

Author information

1
Department of Nephrology and Transplantation, Beaumont Hospital, Dublin 9, Ireland. johnaoregan@physicians.ie.
2
Department of Nephrology and Transplantation, Beaumont Hospital, Dublin 9, Ireland.
3
Renal Laboratory, Department of Biochemistry, Beaumont Hospital, Dublin 9, Ireland.

Abstract

AIMS:

The purpose of this study is to investigate tacrolimus trough-level variability from 3 to 12 months following transplantation and its association with allograft survival in renal transplant recipients.

MATERIALS AND METHODS:

In this observational cohort study, tacrolimus trough-level variability was used as the predictor of all-cause allograft failure (defined as return to dialysis) and patient survival (all-cause mortality).

RESULTS:

In total, 394 transplants were included in the analysis. Sixty-two transplants failed during the study. Tacrolimus trough-level variability across quartile groups were: Q1 median variability 12.5 %, range 4.76-15.71 % (n = 99), Q2 median variability 18.17 %, range 15.74-21.29 % (n = 96), Q3 median variability 24.63 % range 21.42-28.88 % (n = 100), Q4 median variability 36.91 %, range 28.91-81.9 % (n = 99). Higher tacrolimus trough-level variability was associated with inferior allograft survival in univariate models [hazard ratio per quartile increase (HR), 1.46, 95 % CI 1.16-1.83, p value = 0.001] and multivariate models (HR 1.36, 95 % CI 1.05-1.78, p value = 0.019). Higher tacrolimus trough-level variability was not associated with patient survival; univariate model (HR 1.25, 95 % CI 0.90-1.74, p value = 0.17), multivariate model (HR 1.25, 95 % CI 0.86-1.83, p value = 0.23).

CONCLUSIONS:

Inferior renal allograft survival was observed in recipients with higher variability in tacrolimus trough-levels.

KEYWORDS:

Kidney; Tacrolimus; Transplantation; Variability

PMID:
26374111
DOI:
10.1007/s40620-015-0230-0
[Indexed for MEDLINE]

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