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Long-term Clinical Significance of Tacrolimus Trough Level at the Early Period After Kidney Transplantation

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Author(s)
Woo Yeong ParkJin Hyuk PaekKyubok JinSung Bae ParkSeungyeup Han
Keimyung Author(s)
Park, Woo YoungPaek, Jin HyukJin, Kyu BokPark, Sung BaeHan, Seung Yeup
Department
Dept. of Internal Medicine (내과학)
Journal Title
Transplantation proceedings
Issued Date
2019
Volume
51
Issue
8
Abstract
Background:
The stable immunosuppressant level at the early period after kidney transplantation (KT) is one of the most important factors for the prognosis of KT. However, the extent of immunosuppression varies according to the policies of each KT center. We investigated the relationship between the clinical outcome and tacrolimus trough level (TTL) at the early post-transplant period.

Materials and Methods:
We retrospectively analyzed medical records of patients who underwent KT between July 2007 and June 2016. We investigated TTLs at 3 months after KT. We evaluated the incidence of biopsy-proven acute rejection (BPAR), cytomegalovirus infection, and graft survival according to the TTLs.

Results:
A total of 426 patients who received KT during the study period were enrolled. The mean age of KT recipients was 46.3 ± 11.5 years, and 55.5% of patients were men. The incidence of BPAR within 1 year after KT was significantly higher when TTLs at 3 months were less than 4.0 ng/mL ( P = .020). Death-censored graft survival rates were significantly lower in KT recipients with BPAR and TTL less than 4.0 ng/mL ( P < .001, P < .001, respectively). In multivariate analysis, BPAR and TTL less than 4.0 ng/mL at 3 months after KT were independent risk factors for graft failure.

Conclusion:
BPAR and TTL less than 4.0 ng/mL at 3 months after KT are important risk factors for allograft failure. Therefore, TTL should be kept at least 4.0 ng/mL or more at 3 months after KT to reduce the incidence of BPAR within 1 year after KT.
Keimyung Author(s)(Kor)
박우영
백진혁
진규복
박성배
한승엽
Publisher
School of Medicine (의과대학)
Citation
Woo Yeong Park et al. (2019). Long-term Clinical Significance of Tacrolimus Trough Level at the Early Period After Kidney Transplantation. Transplantation proceedings, 51(8), 2643–2647. doi: 10.1016/j.transproceed.2019.03.065
Type
Article
ISSN
1873-2623
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0041134519300697
DOI
10.1016/j.transproceed.2019.03.065
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42420
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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