Tacrolimus and Mycophenolate Exposure and Subclinical Tubulo-Interstitial Inflammation in Low Immunological Risk Renal Transplants.
1Nephrology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
2Transplant Medicine, Rikshospitalet Oslo University Hospital, Oslo, Norway
Meeting: 2017 American Transplant Congress
Abstract number: D124
Keywords: FK506, Kidney transplantation, Mycophenolate mofetil, T cell graft infiltration
Session Information
Session Name: Poster Session D: Kidney: Acute Cellular Rejection
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
The aim is to evaluate the relationship between maintenance immunosuppression, subclinical inflammation (i-score plus t-score) and interstitial fibrosis/tubular atrophy (IF/TA) (ci-score plus ct-score) in paired surveillance biopsies performed in low immunological risk renal transplants treated with induction therapy, tacrolimus, mycophenolate mofetil (MMF) and steroids in two cohorts of patients. The Barcelona cohort consisted of 109 early (4 months) and 66 late (18 months) biopsies in patients receiveng high tacrolimus exposure (C0 taget at 1 year 6 to 10 [micro]g/L) and reduced MMF dose (500 mg bid at 1year). The Oslo cohort consisted of 308 early (1.5 months) and 284 late (12 months) biopsies performed in patients treated with low tacrolimus exposure (C0 target at 1year 3 to 7 [micro]g/L) and standard MMF dose (750 mg bid at 1year). Subclinical tubulo-intersitial inflammation was associated with low tacrolimus trough levels (TAC0) in the early (OR: 0.75, 95% CI: 0.61-0.92; p=0.006) and late biopsies (OR: 0.69, 95% CI: 0.50-0.95; p=0.023) in the Barcelona cohort. In the Oslo cohort, subclinical inflammation was associated with low MMF daily dose in the early biopsy (OR: 0.91, 95% CI: 0.85-0.98; p=0.0162) and with low TAC0 in the late biopsy (OR: 0.80, 95% CI: 0.66-0.97; p=0.0258) after adjusting for confounding variables. IF/TA in the late biopsy was not associated with TAC0 or MMF dose in any of the two cohorts. At one year de novo donor specifc antibodies (dnDSA) were not observed in the Barcelona cohort and were present in 19 out of 283 patients from the Oslo cohort (p=0.03).
Our data suggest that concomitant minimization of TAC and MMF early after transplantation may favour the appearance of subclinical inflammation and dnDSA.
CITATION INFORMATION: Torres I, Reisaeter A, Moreso F, Asberg A, Perello M, Dörje C, Sellares J, Midtved K, Holdaas H, Seron D. Tacrolimus and Mycophenolate Exposure and Subclinical Tubulo-Interstitial Inflammation in Low Immunological Risk Renal Transplants. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Torres I, Reisaeter A, Moreso F, Asberg A, Perello M, Dörje C, Sellares J, Midtved K, Holdaas H, Seron D. Tacrolimus and Mycophenolate Exposure and Subclinical Tubulo-Interstitial Inflammation in Low Immunological Risk Renal Transplants. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/tacrolimus-and-mycophenolate-exposure-and-subclinical-tubulo-interstitial-inflammation-in-low-immunological-risk-renal-transplants/. Accessed May 25, 2025.« Back to 2017 American Transplant Congress