Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Tacrolimus is the key drug in clinical transplant, which has narrow therapeutic index. A few studies reported the association of tacrolimus metabolism rate with the renal transplant outcomes. Different ethnic background might be associated with different tacrolimus metabolism rate from distinct CYP3A5 polymorphism distribution. However, there have not been a large scale report to investigate tacrolimus metabolism rate in the Asian region.
*Methods: Patients included in Korean Organ Transplantation Registry (KOTRY) were used. Kidney transplant recipients who have been transplanted from 2014 to 2017 were enrolled. Tacrolimus metabolism rate was calculated by following equation: tacrolimus trough concentration (ng/ml) / tacrolimus daily dose (mg). The multivariable adjusted association between tacrolimus metabolism rate and renal outcomes including biopsy proven acute rejection, estimated glomerular filtration rate (eGFR), and interstitial fibrosis at renal biopsy were studied.
*Results: Among 3,597 patients, 2,884 patients who were using tacrolimus at the 6 months after transplantation were included to the analysis. Tacrolimus metabolism rate at the 6 months after transplantation were divided by tertile groups. (High vs. mid vs. low metabolism groups) There was no significant association of tacrolimus metabolism with biopsy proven acute rejection. At the multivariable analysis, low tacrolimus metabolism group was associated with better concurrent eGFR (beta coefficient 3.290 (95% C.I. 1.411 – 5.170, p = 0.001). Tacrolimus metabolism was not associated with consecutive eGFR at 1 year after transplantation. Interstitial fibrosis was not associated with tacrolimus metabolism in 6 months all-cause kidney biopsies. However, low tacrolimus metabolism group was associated with lesser interstitial fibrosis (OR 0.183, 95% C.I 0.051 – 0.064, p=0.010) at consecutive 1 year all-cause kidney biopsies.
*Conclusions: Low tacrolimus metabolism rate showed eGFR preservation in 6 months after kidney transplantation. eGFR preservation of low tacrolimus metabolism disappeared after 1 year, however, alleviated interstitial fibrosis was found in low tacrolimus metabolism group.
To cite this abstract in AMA style:Jeong J, Ro H, Koo T, Yang J, Kim M, Shin S, Park J, Ban T, Han S, Kim T, Ahn C. The Reduced Tacrolimus Metabolism Rate and Its Association with Estimated Glomerular Filtration Rate and Interstitial Fibrosis: A Study Using Korean Organ Transplantation Registry (KOTRY) Dataset [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/the-reduced-tacrolimus-metabolism-rate-and-its-association-with-estimated-glomerular-filtration-rate-and-interstitial-fibrosis-a-study-using-korean-organ-transplantation-registry-kotry-dataset/. Accessed August 15, 2020.
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