High Tacrolimus Dose Requirements at Month 6 Are Associated with Inferior Graft Function in Renal Transplant Patients.
Department of Nephrology, Charité
Universitaetsmedizin, Berlin, Germany.
Meeting: 2016 American Transplant Congress
Abstract number: B119
Keywords: Immunosuppression, Kidney transplantation, Outcome
Session Information
Session Name: Poster Session B: Drug Minimization
Session Type: Poster Session
Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction: Tacrolimus (Tac), the mainstay of immunosuppression in renal transplant (tx) patients (pts) is known for drug induced nephrotoxicity, which may limit graft survival.
Methods: In this retrospective analysis all Tac+mycophenolic acid treated renal tx pts (03/1996-11/2014) in our center were included. MDRD GFR was calculated on day (d) 7 + month (m) 6. Dose-normalized Tac trough levels (dnTacTL) on d7 and m6 were divided in tertiles (group 1: <0.75; group 2: <1.7; group 3: >1.7ng/ml mg/day). On d7 and m6 GFR was compared between the groups. Graft loss, rejections + death within 1 year (y) post-tx were analysed.
Results: 608pts were included into analysis (male=380/608pts, 62.50%).
On day 7, large differences in dnTacTL doses were observed and most patients were in the low dnTacTL group. Outcome parameters did not differ between groups.
On month 6 ,most pts were in high dnTacTL group with lowest Tac dose requirement. Pts in the low dnTacTL group had significant lower renal function, highest rejection rate (BANFF09 I-III) and more graft losses, while best outcome was found in high dnTacTL group.
Conclusion: This analysis demonstrates that pts requiring higher tac doses are at greater risk for inferior graft function + graft loss.
| low dnTacTL | middle dnTacTL | high dnTacTL | p-value | |
| day 7 post-tx | n=271 | n=129 | n=66 | |
| dnTacTL (ng/ml mg/day), mean±SD | 0.48±0.16 | 1.05±0.24 | 3.65±2.14 | n.d. |
| Tac trough level (ng/ml), mean±SD | 8.34±2.70 | 11.58±4.58 | 13.97±10.86 | <0.001 |
| Tac dose (mg/day), mean±SD | 18.50±6.25 | 11.34±4.32 | 4.87±4.28 | <0.001 |
| MDRD (ml/min/1.73m²), mean±SD | 25.79±20.54 | 26.94±23.13 | 27.33±19.42 | 0.798 |
| Rejections, pts (%) | 53 (19.6%) | 18 (14.0%) | 10 (14.9%) | 0.319 |
| Tx loss, pts(%) | 9 (3.7%) | 2 (1.7%) | 5 (7.9%) | 0.119 |
| Death, pts (%) | 4 (1.6%) | 3 (2.5%) | 4 (6.6%) | 0.095 |
| month 6th post-tx | n=52 | n=202 | n=262 | |
| dnTacTL (ng/ml mg/day), mean±SD | 0.55±0.17 | 1.25±0.26 | 3.29±0.20 | n.d. |
| Tac trough level (ng/ml), mean±SD | 5.96±2.85 | 7.27±2.45 | 8.62±3.19 | <0.001 |
| Tac dose (mg/day), mean±SD | 10.91±5.14 | 6.09±2.57 |
3.16±1.57 |
<0.001 |
| MDRD (ml/min/1.73m²), mean±SD | 34.18±16.58 | 43.23±17.39 | 48.27±16.61 | <0.001 |
| Rejections, pts (%) | 16 (31.4%) | 49 (24.3%) | 48 (18.2%) | 0.065 |
| Tx loss, pts(%) | 6 (13.0%) | 1 (1.0%) | 1 (1.0%) | <0.001 |
| Death, pts (%) | 3 (6.8%) | 1 (0.5%) | 3 (1.3%) | 0.027 |
| n.d.=not determined |
CITATION INFORMATION: Rissling O, Brakemeier S, Lehner L, Halleck F, Staeck O, Schmidt D, Budde K. High Tacrolimus Dose Requirements at Month 6 Are Associated with Inferior Graft Function in Renal Transplant Patients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Rissling O, Brakemeier S, Lehner L, Halleck F, Staeck O, Schmidt D, Budde K. High Tacrolimus Dose Requirements at Month 6 Are Associated with Inferior Graft Function in Renal Transplant Patients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/high-tacrolimus-dose-requirements-at-month-6-are-associated-with-inferior-graft-function-in-renal-transplant-patients/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress