Variability in Tacrolimus Concentrations Across Pediatric Solid Organ Transplants.
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 October 1, 2020.« Back to 2017 American Transplant Congress