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Relationship Between Tacrolimus Blood Levels and Covid-19 Pandemic in Kidney Transplant Recipients

T. Inoue1, K. Unagami,2, A. Ishiwatari3, T. Kanzawa3, T. Shimizu3, K. Omoto3, M. Inui3, T. Suzuki1, H. Ishida4, K. Tanabe3

1Department of Nephrology, Kameda Medical Center, Chiba Kamogawa, Japan, 2Department of Organ Transplant Medicine, Tokyo Women’s Medical University, Tokyo, Japan, 3Department of Urology, Tokyo Women’s Medical University, Tokyo, Japan, 4Department of Organ transplant medicine, Tokyo Women’s Medical University, Tokyo, Japan

Meeting: 2021 American Transplant Congress

Abstract number: 741

Keywords: Calcineurin, Infection, Kidney transplantation

Topic: Clinical Science » Infectious Disease » All Infections (Excluding Kidney & Viral Hepatitis)

Session Information

Session Name: All Infections (Excluding Kidney & Viral Hepatitis)

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: The novel coronavirus 2019 infection (COVID-19) caused a pandemic, prompting Tokyo, Japan, to restrict on the free movement of people in March 2020. Kidney transplant recipients are at high risk for critical COVID-19 due to chronic immunosuppression and coexisting conditions. For the follow-up of kidney transplant recipients during this pandemic, the number of hospital visits or use remote counseling should be reduced to minimize the risk of infection. However, the management of kidney transplant recipients during the COVID-19 pandemic is uncertain.

*Methods: This single-center retrospective observational study included 980 patients who, more than a year previously, had undergone kidney transplantation and were taking extended-release tacrolimus once a day, with a target trough level of 4 to 6 ng/ml. We evaluated the effects of coronavirus pandemic on clinical outcomes such as tacrolimus blood level, renal function, and rejection in kidney transplant recipients, comparing pandemic data with non-pandemic data obtained between September 2019 and August 2020 in our hospital.

*Results: Comparing pandemic data with non-pandemic data, the mean interval between hospital visits was 5.5±2.6 vs. 7.3±4.5 weeks (P=2.68×10-14). Serum Cr levels and rejection rates after kidney transplant showed no significant differences between both groups. There were no significantly differences in the coefficient of variation (CV) in tacrolimus blood levels, the rate of changes in oral medication, and the rate of deviation from the target trough level during the pandemic.

*Conclusions: In kidney transplant recipients, blood levels of tacrolimus were maintained at target trough levels during the COVID-19 pandemic.

Clinical features in kidney transplant patients
number 980
age 54.7±12.5
male,n,% 603(61.5%)
elapsed time after transplantation, years 9.1±6.3年
diabetic mellitus,n,% 130(13.2%)
living kidney transplantation,n.% 935(95.4%)
ABO incompatible, n , % 120(12.2%)
Cr , mg/dl 1.56±1.02
Clinical outcome between pandemic and non-pandemic
non-pandemic pandemic P value
interval between hospital visit ,week. 5.5±2.6 7.3±4.5 2.68×-14
rate of changes in oral medication 0.077 ±0.34 0.06 ±0.67 0.450
rate of deviation from the target trough level 0.35±0.28 0.38±0.27 0.134
coefficient of variation 15.4±7.2 14.8±7.6 0.162
Cr 1.56±1.0 1.60±1.1 0.481
rejection 0 3 0.084
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To cite this abstract in AMA style:

Inoue T, Unagami K, Ishiwatari A, Kanzawa T, Shimizu T, Omoto K, Inui M, Suzuki T, Ishida H, Tanabe K. Relationship Between Tacrolimus Blood Levels and Covid-19 Pandemic in Kidney Transplant Recipients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/relationship-between-tacrolimus-blood-levels-and-covid-19-pandemic-in-kidney-transplant-recipients/. Accessed May 16, 2025.

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