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

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).

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 February 18, 2020.

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