Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Liver transplantation (LT) is a life-saving procedure in patients with end stage liver disease. After LT, immunosuppresive regimens are needed in order to prevent graft rejection. One of the most commonly used immunosuppressant is tacrolimus, a calcineurin inhibitor, and maintaining proper trough level is recommended after LT. In previous studies, the intra-variability of serum tacrolimus level (STL) is reported to be related to late acute rejection or chronic rejection in both pediatric and adult populations. This study was aimed to investigate whether there was a relationship between the variability of STL and incidence of acute rejection in Korean pediatric patients.
*Methods: The medical records of fifty-eight LT recipients aged from 0 to 20 years old who received LT at Severance Hospital were retrospectively reviewed in the study. Eight cases who either received re-transplantation within the follow-up period or died within 7 days after LT were excluded, and we obtained clinical factors and laboratory results indicating the liver function before LT, donor characteristics, and STL in 50 patients from day 0 to day 30. Intra-variability of STL was determined i) coefficient of variation (CV) and ii) the average of STL (ASTL). The statistical analysis was performed using SPSS v. 25.0 (IBM Corp., Armonk, NY, USA)
*Results: The episode of acute rejection in 50 patients occurred in 20 %, and it was not correlated with STL CV or ASTL. Area under receiver operating curve (AUROC) of the STL CV was 0.58 with no statistical significance (p value = 0.438). When the patients were divided into two groups according to the cutoff level of STL CV (51.57), they did not show any significant differences in baseline characteristics, laboratory results before LT, and the donor characteristics. AUROC of ASTL was 0.615 without statistical significance (p value = 0.26), and the cutoff value was 8.05. There was no differences in the two groups categorized by the ASTL cutoff value except the total bilirubin level before LT (p value = 0.02, respectively).
*Conclusions: STL CV and ASTL are not related to the acute rejection in Korean pediatric patients who received LT.
To cite this abstract in AMA style:Lim H, Koh H, Kim S, Park S, Kang Y, Kim M, In K. Relationship between Tacrolimus Levels and Short-Term Outcome in Korean Pediatric Patients with Liver Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/relationship-between-tacrolimus-levels-and-short-term-outcome-in-korean-pediatric-patients-with-liver-transplantation/. Accessed April 15, 2021.
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