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Variability index of tacrolimus serum levels in pediatric liver transplant recipients younger than 12 years: Non‐adherence or risk of non‐adherence?
Author(s) -
Oliveira Janete Teresinha Pires,
Kieling Carlos Oscar,
Silva Anaís Back,
Stefani Joel,
Witkowski Maria Carolina,
Smidt Camila Ribas,
Mariano da Rocha Carolina R,
Hirakata Vania Naomi,
Grossini Maria da Graça,
Zanotelli Maria Lúcia,
Gonçalves Vieira Sandra Maria
Publication year - 2017
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13058
Subject(s) - medicine , biliary atresia , liver transplantation , socioeconomic status , statistical significance , tacrolimus , transplantation , pediatrics , retrospective cohort study , chi square test , population , statistics , mathematics , environmental health
Abstract MLVI has been used to assess adherence. To determine the MLVI in children <12 years of age at transplantation and to identify demographic correlates and consequences for the graft. This is a retrospective study of 50 outpatients (4.0 ± 3.5 years), at least 13‐month post‐liver transplantation. The outcomes evaluated were MLVI, ALT > 60 IU/L, ACR, death, and graft loss. We analyzed demographic and socioeconomic characteristics, indication for transplantation, and type of donor. Student's t test and the chi‐square test were used. Statistical significance was set at P ≤ .05. Seventy‐two percent were infants or preschoolers, 62% biliary atresia. Seventy‐four percent of the mothers had middle‐school education, and 54% of the families had an income ≤3632.4 US$/y. Twenty‐two (44%) patients had a MLVI ≥ 2 SD; this was more prevalent in families with higher incomes ( P = .045). ALT levels > 60 IU/L were more common in MLVI ≥ 2 SD group ( P = .035). ACR episodes were similar between groups ( P = 1.000). No patient died or lost the graft. MLVI ≥ 2 SD may be an indicator of the risk of medication non‐adherence.