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Variability in Tacrolimus Concentrations Across Pediatric Solid Organ Transplants.

S. Min,1 T. Daljevic,1 O. Lee,1 M.-E. Alary,6 F. Murdoch,5 R. Parekh,1 V. Ng,1 D. Hebert,1 L. Hamiwka,2 T. Blydt-Hansen,3 V. Phan,4 P. Birk,3 U. Allen,1 S. Urschel,5 CNTRP POSITIVE Research Group, B. Foster,6 S. Mital.1

1The Hospital for Sick Children, Toronto, Canada
2Alberta Children's Hospital, Calgary, Canada
3University of Winnipeg, Winnipeg, Canada
4Université
de Montréal, Motreal, Canada
5Stollery Children's Hospital, Edmonton, Canada
6McGill University, Montreal, Canada

Meeting: 2017 American Transplant Congress

Abstract number: B276

Keywords: Calcineurin, Immunosuppression, Multicenter studies, Outcome

Session Information

Date: Sunday, April 30, 2017

Session Name: Poster Session B: Pediatric Liver Transplant - Clinical

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Related Abstracts
  • A Pilot Trial of Genotype-Guided Dosing versus Standard Clinical Dosing in Pediatric Solid Organ Transplants.
  • Tacrolimus Precision Medicine: Antibiotics Increase Intra-Patient Variability in Tacrolimus Trough Concentrations in Kidney Transplant Recipients.

PURPOSE: We characterized the evolution of out-of-range tacrolimus (TAC) concentrations and associated factors during 1 year following a pediatric solid organ transplant (SOT).

METHODS: Heart, kidney and liver transplant recipients were enrolled in the study. TAC concentrations at 36-48 hours post TAC, 7, 14, 30 days, 3 & 12 months post-transplant were captured. The association of time after transplant and organ type with out-of-target concentrations was analyzed.

RESULTS: 216 SOT recipients(83 heart, 65 kidney and 68 liver) were included. 77% had out-of-target at 36-48 hours(21% supra-therapeutic, 56% sub-therapeutic). By 1 year, 43% had out-of-target(35% supra-therapeutic, 8% sub-therapeutic). There was a decline in sub-therapeutic and an increase in supra-therapeutic with time (p<0.001). After adjusting for age, race and time, heart transplants had lower odds of sub-therapeutic (OR[CI]=0.53[0.37,0.76]) and higher odds of supra-therapeutic compared to kidney(OR[CI]=1.72[1.20,2.48]).

Organ Type Adjusted OR 95% CI P
Overall out of range Kidney 1.00
Heart 0.89 0.64,1.23 0.467
Liver 1.05 0.75,1.46 0.782
Sub-therapeutic Kidney 1.00
Heart 0.53 0.37,0.76 0.001
Liver 0.80 0.56,1.15 0.231
Supra-therapeutic Kidney 1.00
Heart 1.72 1.20,2.48 0.004
Liver 1.39 0.96,2.03 0.085

CONCLUSION: SOT recipients have high variability in TAC levels during 1 year follow-up which varies by organ. Clinical and demographic factors partially account for the variability.

CITATION INFORMATION: Min S, Daljevic T, Lee O, Alary M.-E, Murdoch F, Parekh R, Ng V, Hebert D, Hamiwka L, Blydt-Hansen T, Phan V, Birk P, Allen U, Urschel S, CNTRP POSITIVE Research Group, Foster B, Mital S. Variability in Tacrolimus Concentrations Across Pediatric Solid Organ Transplants. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Min S, Daljevic T, Lee O, Alary M-E, Murdoch F, Parekh R, Ng V, Hebert D, Hamiwka L, Blydt-Hansen T, Phan V, Birk P, Allen U, Urschel S, Group CNTRPPOSITIVEResearch, Foster B, Mital S. Variability in Tacrolimus Concentrations Across Pediatric Solid Organ Transplants. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/variability-in-tacrolimus-concentrations-across-pediatric-solid-organ-transplants/. Accessed January 24, 2021.

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