Tacrolimus trough levels higher than 6 ng/mL might not be required after a year in stable kidney transplant recipientsopen access
- Authors
- Jung, HY[Jung, Hee-Yeon]; Seo, MY[Seo, Min Young]; Jeon, Y[Jeon, Yena]; Huh, KH[Huh, Kyu Ha]; Park, JB[Park, Jae Berm]; Jung, CW[Jung, Cheol Woong]; Lee, S[Lee, Sik]; Han, SY[Han, Seung-Yeup]; Ro, H[Ro, Han]; Yang, JS[Yang, Jaeseok]; Ahn, C[Ahn, Curie]; Choi, JY[Choi, Ji-Young]; Cho, JH[Cho, Jang-Hee]; Park, SH[Park, Sun-Hee]; Kim, YL[Kim, Yong-Lim]; Kim, CD[Kim, Chan-Duck]
- Issue Date
- 2-Jul-2020
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.15, no.7
- Indexed
- SCIE
SCOPUS
- Journal Title
- PLOS ONE
- Volume
- 15
- Number
- 7
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/3902
- DOI
- 10.1371/journal.pone.0235418
- ISSN
- 1932-6203
- Abstract
- Background Little is known regarding optimal tacrolimus (TAC) trough levels after 1 year post-transplant in stable kidney transplant recipients (KTRs) who have not experienced renal or cardiovascular outcomes. This study aimed to investigate the effect of 1-year post-transplant TAC trough levels on long-term renal and cardiovascular outcomes and opportunistic infections in stable KTRs. Methods KTRs receiving TAC with mycophenolate-based immunosuppression who did not experience renal or cardiovascular outcomes within 1 year post-transplant were enrolled from a multicenter observational cohort study. Renal outcome was defined as a composite of biopsy-proven acute rejection, interstitial fibrosis and tubular atrophy, and death-censored graft loss. Cardiovascular outcome was defined as a composite of de novo cardiomegaly, left ventricular hypertrophy, and cardiovascular events. Opportunistic infections were defined as the occurrence of BK virus or cytomegalovirus infections. Results A total of 603 eligible KTRs were divided into the low-level TAC (LL-TAC) and high-level TAC (HL-TAC) groups based on a median TAC level of 5.9 ng/mL (range 1.3-14.3) at 1 year post-transplant. The HL-TAC group had significantly higher TAC trough levels at 2, 3, 4, and 5 years compared with the levels of the LL-TAC group. During the mean follow-up of 63.7 +/- 13.0 months, there were 121 renal outcomes and 224 cardiovascular outcomes. In multivariate Cox regression analysis, LL-TAC and HL-TAC were not independent risk factors for renal and cardiovascular outcomes, respectively. No significant differences in the development of opportunistic infections and de novo donor-specific anti-human leukocyte antigen antibodies and renal allograft function were observed between the two groups. Conclusions TAC trough levels after 1 year post-transplant remained at a similar level until the fifth year after kidney transplantation and were not directly associated with long-term outcomes in stable Korean KTRs who did not experience renal or cardiovascular outcomes. Therefore, in Asian KTRs with a stable clinical course, TAC trough levels higher than approximately 6 ng/mL might not be required after a year of kidney transplantation.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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