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/1.73mÂ²), 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||
|MDRD (ml/min/1.73mÂ²), 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|
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 February 27, 2021.
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