Date: Saturday, May 30, 2020
Session Name: Poster Session B: Liver: Immunosuppression and Rejection
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: It is well described that there is interpatient variability in tacrolimus dose requirements among transplant recipients. CYP3A5 plays a role in this variability. Black donors are more likely to be CYP3A5 *1 expressers compared to Caucasians. Due to this difference, this study aims to compare tacrolimus dosing requirements of tacrolimus-IR (tac-IR) and tacrolimus-XR (LCPT) in Caucasian liver transplant (OLT) recipients receiving a liver from Black or Caucasian donors.
*Methods: This single-center retrospective analysis included patients that received an OLT who were transitioned from tac-IR to LCPT and remained on LCPT for at least 3 months. A matched control group of patients on tac-IR were also compared. Patients were divided into groups based on donor race and tacrolimus formulation. The primary endpoint was defined as total daily weight adjusted tacrolimus dose (mg/kg)/(ng/mL) calculated at 3 and 6 months post-transplant. Composite of graft loss, death and biopsy-proven rejection (BPAR) were compared by donor race for tac-IR and LCPT at 1 year post-OLT. Differences in the primary and composite endpoints were evaluated via Chi-square analysis and independent samples t-test where appropriate.
*Results: There were 90 patients who received a Caucasian donor liver and 19 patients that received a Black donor liver. There was no difference in recipient demographic variables of age, sex, BMI and MELD score at the time of OLT. There was no difference in Tac-IR weight adjusted dose requirements (mg/kg)/(ng/mL) between Caucasian and Black donors at 3 months (p=0.33) and 6 months post-OLT (p=0.18). There was no difference incidence of BPAR between the two donor group for Tac-IR (7% vs. 1%, p=0.47). Similar results for the LCPT group, with no difference in LCPT weight adjusted dose requirements between Caucasian and Black donors at 3 months (p=0.36) and 6 months post-OLT (p=0.27). Incidence of BPAR between the two donor groups (11% vs. 3%, p=0.27) we not different.
*Conclusions: In the early post-transplant period, there is no difference in tacrolimus dose requirements in Caucasian OLT recipients based on donor race.
|Caucasian Donor (n=42)||Black Donor (n=12)||P-value|
|Tac-IR at 3 month (mg/kg) /(ng/mL)||0.017 ± 0.012||0.021 ± 0.013||0.33|
|Tac-IR at 6 month (mg/kg)/(ng/mL)||0.014 ± 0.009||0.018 ± 0.012||0.18|
|1 year composite (n, %)||7 (16.7)||1 (8.3)||0.47|
|Caucasian Donor (n=47)||Black Donor (n=7)||P-value|
|LCPT at 3 month (mg/kg) /(ng/mL)||0.011 ± 0.011||0.013 ± 0.004||0.75|
|LCPT at 6 month (mg/kg) /(ng/mL)||0.014 ± 0.014||0.021 ± 0.020||0.36|
|1 year composite (n, %)||11 (23.4)||3 (42.8)||0.27|
To cite this abstract in AMA style:Nesselhauf N, January S, Hagopian J, Progar K, Khan A. Impact of Donor Race on Tacrolimus Dose Requirement for Liver Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-donor-race-on-tacrolimus-dose-requirement-for-liver-transplant-recipients/. Accessed October 26, 2020.
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