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Higher tacrolimus trough levels on days 2–5 post‐renal transplant are associated with reduced rates of acute rejection
Author(s) -
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.
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01021.x
Subject(s) - medicine , tacrolimus , quartile , urology , renal transplant , trough level , gastroenterology , prednisolone , kidney , surgery , transplantation , confidence interval
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.