Erratic tacrolimus levels at 6 to 12 months post-lung transplant predicts poor outcomes

Background: It has previously been described that erratic tacrolimus blood levels are associated with graft failure in kidney and liver transplantation. Using a small cohort, we previously described that a higher tacrolimus standard deviation (SD) 6 to 12 months after lung transplantation increased...

Full description

Saved in:
Bibliographic Details
Published in:JHLT Open 2024-02, Vol.3, p.100043, Article 100043
Main Authors: Walters, Samuel, Yerkovich, Stephanie, Hopkins, Peter M, Leisfield, Trish, Winks, Lesleigh, Chambers, Daniel C, Divithotawela, Chandima
Format: Article
Language:English
Subjects:
chronic lung allograft dysfunction
Coefficient of variance
lung transplant
survival
tacrolimus
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: It has previously been described that erratic tacrolimus blood levels are associated with graft failure in kidney and liver transplantation. Using a small cohort, we previously described that a higher tacrolimus standard deviation (SD) 6 to 12 months after lung transplantation increased the risk of chronic lung allograft dysfunction (CLAD) and death. We aimed to assess this in a larger cohort using the coefficient of variation (CoV) and identify potential risk factors for higher CoV. Methods: We retrospectively reviewed 351 lung transplant recipients who received tacrolimus-based immunosuppression therapy. Cox proportional hazard modeling was used to investigate the effects of mean tacrolimus and CoV levels on survival and CLAD. Results: Tacrolimus CoV from 6 to 12 months was independently associated with both CLAD (hazard ratio [HR], 19.99; 95% CI, 7.55-52.91; p 
ISSN:2950-1334
2950-1334
DOI:10.1016/j.jhlto.2023.100043