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Medical Science Monitor Basic Research


eISSN: 2329-0358

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Effect of different tacrolimus levels on early outcomes after kidney transplantation

Shehzad Rehman, Xuerong Wen, Michael J. Casey, Alfonso H. Santos, Kenneth Andreoni

(Division of Nephrology, Hypertension & Renal Transplantation, Department of Medicine, University of Florida, Gainesville, USA)

Ann Transplant 2014; 19:68-75

DOI: 10.12659/AOT.889858

Background: There is a paucity of modern data on the impact of high tacrolimus levels early after kidney transplantation.
Material and Methods: This study analyzed the impact of various trough levels of tacrolimus in the first 2 weeks post-transplant on rates of delayed graft function (DGF), length of stay (LoS), hyperkalemia, hyperglycemia, and biopsy-proven acute rejection (BPAR) rates in the first 3 months post-transplant in a retrospective single-center cohort of patients. Patients were divided into 4 groups based on the average of two highest 12-hour trough tacrolimus levels: <10 ng/mL, 10–12 ng/mL, 12–15 ng/mL, >15 ng/mL.
Results: The incidence of DGF was noted to be significantly higher in the <10 ng/mL, >15 ng/mL and the 12–15 ng/mL tacrolimus groups as compared to the 10–12 ng/mL group (49%, 25% and 4%, respectively, p=<0.0001). Mean LoS was also noted to be significantly higher in the >15 ng/mL tacrolimus group as compared to the 10–12 ng/mL group (7.4 days and 6.1 days respectively, p=0.0007). There was no difference in the rates of hyperkalemia, hyperglycemia or BPAR.
Conclusions: This is a modern confirmation of the association between higher tacrolimus levels early after kidney transplantation and increased rate of DGF and increased LoS.

Keywords: Delayed Graft Function, acute rejection, Calcineurin Inhibitor Toxicity

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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