Clinical Significance of Tacrolimus Trough Level at the Early Period after Kidney Transplantation
1Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
2Keimyung University Kidney Institute, Daegu, Republic of Korea.
Meeting: 2018 American Transplant Congress
Abstract number: C101
Keywords: Cytomeglovirus, FK506, Kidney transplantation, Rejection
Session Information
Session Name: Poster Session C: Kidney Immunosuppression: Novel Regimens and Drug Minimization
Session Type: Poster Session
Date: Monday, June 4, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background:The stable immunosuppressant level at the early period after kidney transplantation (KT) is one of the most important factors to decide the prognosis of KT. However, the extent of immunosuppression is varies according to the policies of each KT centers. We investigated the relationship between the clinical outcome and tacrolimus trough levels (TTLs) in the early post-transplant period.
Methods:We retrospectively analyzed the medical records of patients performed KT between July 2007 and June 2016. We investigated TTLs at 1 week, 2 week, 3 week, 1 month, 3 months, 6 months and 12 months after KT.We evaluated the incidence of acute rejection and cytomegalovirus (CMV) infection, and graft survival according to the TTLs.
Results:A total of 429 patients who received KT during the study period were enrolled. The mean age of KTRs was 46.3 ± 11.5years and male was 55.5%. TTLs (ng/mL) at 1 week, 2 week, 3 week, 1 month, 3 months, 6 months and 12 months after KTwere6.2 (5.0 – 7.9), 7.1 (5.8 – 8.6), 7.8 (6.3 – 9.6), 7.6 (6.0 – 9.5), 6.8 (5.5 – 8.4), 6.5 (5.2 – 7.8), and 5.9 (4.8 – 7.1). The incidence of acute rejection within 1 year after KT was significantly higher when TTLs at 3 months was less than 4.0 ng/mL (P = 0.020). On the contrary, the incidence of CMV infection after 1 year was significantly higher when TTLs at 12 months was 10 ng/mL or more (P = 0.015). However, the incidence of CMV infection within 1 year was not associated with TTL within 1 year. Death-censored graft survival rate was significantly lower in KTRs with acute rejection and CMV infection (P < 0.001 and 0.008). In multivariate analysis, TTL less than 4 ng/mL at 3 months after KT was an independent risk factor for graft failure.
Conclusion: Acute rejection and CMV infection are important risk factors for allograft failure. Therefore, TTL should be kept at least 4 ng/mL or more at 3 months after KT to reduce the incidence of acute rejection within 1 year after KT and below 10 ng/mL since 1 year after KT to reduce the incidence of CMV infection since 1 year after KT.
CITATION INFORMATION: Park W., Yeo S., Kang S., Park H., Jin K., Park S., Han S. Clinical Significance of Tacrolimus Trough Level at the Early Period after Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Park W, Yeo S, Kang S, Park H, Jin K, Park S, Han S. Clinical Significance of Tacrolimus Trough Level at the Early Period after Kidney Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/clinical-significance-of-tacrolimus-trough-level-at-the-early-period-after-kidney-transplantation/. Accessed May 8, 2025.« Back to 2018 American Transplant Congress