High Intrapatient Tacrolimus Variability and Increased Cell-Free DNA in Kidney Transplant Recipients.
| Autor: | Kopfman, Miranda, Brokhof, Marissa, Patel, Shree, Fu, Dennis, Olaitan, Oyedolamu |
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| Předmět: |
NUCLEIC acid analysis
KIDNEY transplantation PATIENT compliance ANTILYMPHOCYTIC serum PATIENTS TRANSPLANTATION of organs tissues etc. LIQUID chromatography-mass spectrometry SEX distribution HYPERTENSION MYCOPHENOLIC acid KRUSKAL-Wallis Test FISHER exact test RETROSPECTIVE studies DESCRIPTIVE statistics MANN Whitney U Test PANCREAS transplantation GRAFT rejection LONGITUDINAL method GENETIC variation RACE VENOUS puncture TACROLIMUS RESEARCH methodology MEDICAL records ACQUISITION of data ELECTRONIC health records EXTRACELLULAR space COMPARATIVE studies DRUGS DATA analysis software BIOMARKERS IMMUNOSUPPRESSION DIABETES HLA-B27 antigen DRUG dosage THERAPEUTICS DRUG administration |
| Zdroj: | Progress in Transplantation; Dec2024, Vol. 34 Issue 4, p204-210, 7p |
| Abstrakt: | Introduction: An inverse relationship has been identified between tacrolimus serum concentrations and donor-derived cell-free DNA (dd-cfDNA) levels after lung transplant, but limited data exists on this relationship in the kidney transplant population. Project Aim: The purpose of this evaluation was to examine the relationship between high tacrolimus variability and elevated dd-cfDNA levels in kidney and simultaneous pancreas-kidney transplant recipients at a single center. Design: Single-center, retrospective, descriptive comparative evaluation of kidney and pancreas-kidney transplant recipients who received longitudinal ddcfDNA surveillance. Intrapatient tacrolimus variability was assessed using the coefficient of variation (%CV) measured between 1 and 12 months posttransplant. Pediatrics, retransplant or multiorgan transplant recipients, and pregnant recipients were excluded. Results: One hundred fifteen recipients with 518 dd-cfDNA levels and 3028 tacrolimus troughs were assessed. Pancreas-kidney recipients had significantly higher median dd-cfDNA (0.29% vs. 0.18%, P =.034) and were excluded from analysis. Ninety-nine kidney transplant recipients were included for analysis. Recipients with tacrolimus %CV ≥30 (N = 66) had significantly higher median dd-cfDNA than %CV <30 (0.22% vs. 0.17%, P =.031). Tacrolimus %CV ≥30 demonstrated higher median peak dd-cfDNA than %CV <30, though this was not statistically significant (0.36% vs. 0.28%, P =.058). Conclusion: These data demonstrated that high intrapatient tacrolimus variability may be associated with elevated dd-cfDNA in the first year after kidney transplant. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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