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Verfasst von:Gold, Annika [VerfasserIn]   i
 Tönshoff, Burkhard [VerfasserIn]   i
 Döhler, Bernd [VerfasserIn]   i
 Süsal, Caner [VerfasserIn]   i
Titel:Association of graft survival with tacrolimus exposure and late intra-patient tacrolimus variability in pediatric and young adult renal transplant recipients
Titelzusatz:an international CTS registry analysis
Verf.angabe:Annika Gold, Burkhard Tönshoff, Bernd Döhler & Caner Süsal
Jahr:2020
Umfang:12 S.
Fussnoten:First published: 02 September 2020 ; Gesehen am 13.12.2021
Titel Quelle:Enthalten in: Transplant international
Ort Quelle:Oxford [u.a.] : Wiley-Blackwell, 1988
Jahr Quelle:2020
Band/Heft Quelle:33(2020), 12, Seite 1681-1692
ISSN Quelle:1432-2277
Abstract:Adolescent and young adult age is a high-risk window with an alarmingly increased likelihood of premature kidney graft loss due to immunological rejection. Using the large database of the Collaborative Transplant Study, we analyzed whether a more intense and less variable exposure to tacrolimus could counteract this young age-related enhanced immunoreactivity. Kidney graft recipients aged 12-23 years (n = 964) with a 1-year tacrolimus trough level between 4.0 and 10.9 ng/ml had a 5-year graft survival rate of 85.1%, significantly better than the poor 66.1% rate in patients with a trough level below 4.0 ng/ml who showed a 2.38-fold increased risk of graft loss in the multivariable analysis (P < 0.001). This association was not apparent in young children aged 0-11 years (n = 455) and less pronounced in adults aged 24-34 years (n = 1466). However, an intra-patient variability of tacrolimus (IPV) trough level ≥1.5 at post-transplant years 1 and 2 was associated with an increased graft loss risk in both 12- to 23-year-old and 0- to 11-year-old recipients (P < 0.001 and P = 0.045). Patients with high IPV made up as many as 30% of kidney graft recipients, indicating that a more intense and less variable exposure to tacrolimus could improve graft survival strongly in this high-risk group.
DOI:doi:10.1111/tri.13726
URL:kostenfrei: Volltext ; Verlag: https://doi.org/10.1111/tri.13726
 kostenfrei: Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/tri.13726
 DOI: https://doi.org/10.1111/tri.13726
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:late intra-patient tacrolimus variability
 pediatrics
 renal allograft survival
 tacrolimus exposure
 young adults
K10plus-PPN:1782039678
Verknüpfungen:→ Zeitschrift
 
 
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