دورية أكاديمية
High intra-patient variability of tacrolimus within post-operative 1 month predicted worse 1-year outcomes in pediatric liver transplant recipients.
| العنوان: | High intra-patient variability of tacrolimus within post-operative 1 month predicted worse 1-year outcomes in pediatric liver transplant recipients. |
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| المؤلفون: | Chen F; Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People's Republic of China.; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China., Yong JK; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China., Shen C; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China., Zhou T; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China., Feng M; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China., Wan P; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China., Luo Y; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China., Lin H; Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, People's Republic of China., Qian Y; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China. qianyb79@hotmail.com., Xia Q; Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No. 1630 Dongfang Road, Shanghai, 200127, People's Republic of China. xiaqiang@shsmu.edu.cn. |
| المصدر: | European journal of clinical pharmacology [Eur J Clin Pharmacol] 2024 Jul; Vol. 80 (7), pp. 1017-1027. Date of Electronic Publication: 2024 Mar 19. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Germany NLM ID: 1256165 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1041 (Electronic) Linking ISSN: 00316970 NLM ISO Abbreviation: Eur J Clin Pharmacol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin, New York, Springer. |
| مواضيع طبية MeSH: | Tacrolimus*/pharmacokinetics , Tacrolimus*/therapeutic use , Tacrolimus*/blood , Tacrolimus*/administration & dosage , Liver Transplantation* , Immunosuppressive Agents*/pharmacokinetics , Immunosuppressive Agents*/therapeutic use , Immunosuppressive Agents*/blood , Immunosuppressive Agents*/administration & dosage, Humans ; Male ; Female ; Retrospective Studies ; Infant ; Child ; Child, Preschool ; Graft Rejection/prevention & control ; Adolescent ; Graft Survival ; Postoperative Period ; Treatment Outcome |
| مستخلص: | Background: The pharmacokinetics of tacrolimus (TAC) show high intra-patient variability (IPV), which is associated with poor long-term outcomes following adult liver transplantation (LT). However, this relationship remains to be confirmed in pediatric liver transplant (PLT) recipients. The present study aimed to investigate the association between TAC IPV and grafts or patient outcomes after pediatric liver transplantion. Methods: This retrospective study included 848 PLT recipients (including infants) between January, 2016, and June, 2021. The IPV of TAC concentrations was estimated by calculating the coefficient of variation (CV) of trough concentrations in whole blood within 1 month after transplantation. Patients were categorized into two groups, low IPV (CV < 45%) and high IPV (CV ≥ 45%), based on the third quartile of the CV distribution. Results: A total of 848 patients were included in our study. The low CV group included 614 patients, with a mean TAC trough concentration of 8.59 ± 1.65 ng/ml and a median CV of 32.37%. In contrast, the high CV group included 214 patients, the mean TAC trough concentration and median CV were 8.81 ± 2.00 ng/ml and 54.88%, respectively. The median hospital duration was significantly higher in the high CV group (22 days vs. 20 days, P = 0.01). Univariate analysis was performed to evaluate the significant differences in 1-year recipient survival (P = 0.041) and 1-year graft survival (P = 0.005) between the high- and low-CV groups. Moreover, high CV (HR 2.316, 95%CI 1.026-5.231, P = 0.043) and persistent EBV viremia (HR 13.165, 95%CI 3.090-56.081, P < 0.001) were identified as independent risk factors for 1- year mortality after PLT. Conclusions: PLT recipients with high TAC trough concentration of CV in the first month were associated with poor 1-year outcomes. This CV calculation provides a valuable strategy to monitor TAC exposure. (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Coefficient of variation; Intra-patient variability; Outcome; Pediatric liver transplantation; Tacrolimus |
| المشرفين على المادة: | WM0HAQ4WNM (Tacrolimus) 0 (Immunosuppressive Agents) |
| تواريخ الأحداث: | Date Created: 20240319 Date Completed: 20240606 Latest Revision: 20240606 |
| رمز التحديث: | 20240607 |
| DOI: | 10.1007/s00228-024-03663-z |
| PMID: | 38502358 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1432-1041 |
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| DOI: | 10.1007/s00228-024-03663-z |