Defining a threshold for tacrolimus intra-patient variability associated with late acute cellular rejection in paediatric kidney transplant recipients

Abu Bakar K 1 , Mohamad NA 2 , Hodi Z 3 , McCulloch T 3 , Williams A 1 , Christian M 1 Show all authors , Key T 4 , Kim JJ 5

Affiliations 

  • 1 Department of Paediatric Nephrology, Nottingham University Hospital, Nottingham, UK
  • 2 Institute for Public Health, Kuala Lumpur, Malaysia
  • 3 Department of Histopathology, Nottingham University Hospital, Nottingham, UK
  • 4 Histocompatibility and Immunogenetics Sheffield, NHS Blood and Transplant, Watford, UK
  • 5 Department of Paediatric Nephrology, Nottingham University Hospital, Nottingham, UK. jonjin.kim@nuh.nhs.uk
Pediatr Nephrol, 2019 12;34(12):2557-2562.
PMID: 31520127 DOI: 10.1007/s00467-019-04346-z

Abstract

BACKGROUND: Late acute cellular rejection (LACR) is associated with poorer graft outcomes and non-adherence. Non-adherence to tacrolimus can be indirectly assessed by the intra-patient variability (IPV) of tacrolimus trough levels. The threshold of IPV associated with rejection is not known.

METHODS: We conducted a case-control study comparing 25 patients with biopsy-proven LACR against 25 stable controls matched for age group, primary diagnosis and time post-transplant. IPV was calculated using coefficient of variance (CV) and mean absolute deviation (MAD) using tacrolimus levels in the preceding 12 months. We also assessed the percentage time for tacrolimus levels

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

MeSH terms
Similar publications