Details

Autor(en) / Beteiligte

• O’Regan, John A.
• Canney, Mark
• Connaughton, Dervla M.
• O’Kelly, Patrick
• Williams, Yvonne
• Collier, Geraldine
• deFreitas, Declan G.
• O’Seaghdha, Conall M.
• Conlon, Peter J.

Titel

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

Ist Teil von

• Journal of nephrology, 2016-04, Vol.29 (2), p.269-276

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• 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.