SUN-314 CORRELATION OF PRETRANSPLANT TROUGH TACROLIMUS LEVEL WITH EARLY ACUTE REJECTION IN LIVE DONOR RENAL TRANSPLANTATION

Abstract Background and Aims High donor-recipient age gap among deceased-donor renal transplant patients leads to worse outcomes. However, the impact of this gap among live-donor renal transplants is unclear. The aim of this study is to assess the effect of this age gap on graft survival and acute rejection rates among renal transplants in tacrolimus era. Method 14390 live-donor renal transplant patients who received a single organ transplant, had no previous renal transplants, discharged on tacrolimus-based immunotherapy and were registered in the Organ Procurement Transplantation Network from January 2000 till June 2017 were included in the study. Donor–recipient age difference was divided into 5 groups; group A (difference <−10,n=4375), group B (difference from -10 to 10,n=7229), group C (difference between 10-20, n=861), group D ( difference between 20–29, n=1406) and group E (difference ≥30 years, n=519). Poisson regression analysis was used to assess effect of age gap on acute rejection rates. Kaplan-Meier survival curves and Cox hazard regression analysis were used to assess this effect on graft survival. Results Regarding graft survival, groups with age difference ≥30 years and between 20-29 years showed a significantly higher risk of graft loss when compared to group with age difference <−10 (HR equals 4.6 and 3.8 respectively). Groups with age difference between 10 to 20 years and between -10 to 10 years showed no significant difference in graft survival when compared to same group (HR equals 1.03 and 0.95 respectively). Groups B,C,D,E were not associated with increased risk of acute rejection episodes when compared to group A (IRR=1.001, 1.001, 1.022, 1.027 respectively). Conclusion Donor-recipient age difference up to 20 years has similar renal transplant outcomes to those receiving kidneys from younger donors and therefore, should not be precluded from paired kidney donation programs. The donor-recipient age difference above 20 years is associated with worse outcomes in terms of graft survival.

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Daclizumab in live donor renal transplantation

Transplantation Proceedings ◽

10.1016/s0041-1345(00)00984-2 ◽

2000 ◽

Vol 32 (4) ◽

pp. 790-792 ◽

Cited By ~ 2

Author(s):

A.J Iverson ◽

S.C Vick ◽

C.T Sarnacki ◽

F.H Wright

Keyword(s):

Renal Transplantation ◽

Live Donor

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Association of MCP-1 and CCR2 polymorphisms with the risk of late acute rejection after renal transplantation in Korean patients

International Journal of Immunogenetics ◽

10.1111/j.1744-313x.2007.00725.x ◽

2007 ◽

Vol 0 (0) ◽

pp. 071004004303002-??? ◽

Cited By ~ 1

Author(s):

S. W. Kang ◽

S. J. Park ◽

Y. W. Kim ◽

Y. H. Kim ◽

H. S. Sohn ◽

...

Keyword(s):

Renal Transplantation ◽

Acute Rejection ◽

Korean Patients

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Live donor renal transplantation in patients with end-stage renal failure due to IgA nephropathy: clinicopathological assessment

Nephrology ◽

10.1046/j.1440-1797.7.s3.15.x ◽

2002 ◽

Vol 7 ◽

pp. S74-S77

Author(s):

Yu Seun Kim ◽

Hyeon Joo Jeong ◽

Kye Won Kwon ◽

Ho Yung Lee ◽

Dae Suk Han ◽

...

Keyword(s):

Renal Failure ◽

Renal Transplantation ◽

Iga Nephropathy ◽

Live Donor ◽

End Stage Renal Failure ◽

End Stage

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Neoral reduces the incidence of acute rejection after renal transplantation

Transplantation Proceedings ◽

10.1016/s0041-1345(98)00418-7 ◽

1998 ◽

Vol 30 (5) ◽

pp. 1758-1759 ◽

Cited By ~ 1

Author(s):

S Sandrini ◽

G Setti ◽

P Gaggia ◽

R Chiappini ◽

R Maffeis ◽

...

Keyword(s):

Renal Transplantation ◽

Acute Rejection

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Effectiveness of Valganciclovir 900mg Versus 450mg for Cytomegalovirus Prophylaxis in Renal Transplantation: A Systematic Review and Meta-Analysis

Journal of Pharmacy & Pharmaceutical Sciences ◽

10.18433/j3805b ◽

2017 ◽

Vol 20 ◽

pp. 168 ◽

Cited By ~ 3

Author(s):

Wang Xin ◽

Yang Hui ◽

Zhang Xiaodong ◽

Cui Xiangli ◽

Wang Shihui ◽

...

Keyword(s):

Renal Transplantation ◽

Acute Rejection ◽

Low Dose ◽

Opportunistic Infections ◽

Meta Analysis ◽

High Dose ◽

Renal Transplant Recipients ◽

Significant Difference ◽

Allograft Loss ◽

Cmv Disease

Objectives: Valganciclovir 900 mg/day is approved for cytomegalovirus (CMV) prophylaxis, but 450 mg/day is seems also effective. We systematically reviewed the efficacy and safety of low-dose versus high-dose valganciclovir prophylaxis in renal transplantation recipients. Methods: An electronic search was conducted up to November 29, 2016. The primary outcomes were incidences of CMV, CMV disease, mortality and opportunistic infection. The second outcomes were acute rejection, allograft loss, adverse drug reaction (ADR). Results: 7 cohort studies, all with high quality involving (1431 patients) were included. There was no significant difference of the incidence of following CMV disease (1271 patients, odds ratio [OR] 0.74, 95% confidence interval [CI], 0.38-1.43, p=0.36), acute rejection (1343 patients, OR 0.77, 95%CI 0.53-1.14, p=0.19), allograft loss (1271 patients, OR 0.64, 95%CI 0.31-1.35, p=0.24), mortality (1271 patients, OR 0.55, 95%CI 0.20-1.47, p=0.23) and opportunistic infections (OI) (985 patients, OR 0.76, 95%CI 0.52-1.10, p=0.14) between the low-dose and the high-dose valganciclovir prophylaxis. And no significant difference was observed for premature valganciclovir discontinuation (1010 patients, OR 0.81, 95%CI 0.52-1.25, p=0.33) and the incidence of leukopenia (1082 patients, OR 0.65, 95%CI 0.34-1.22, p=0.18) between the two regimens. Conclusion: 450 mg and 900 mg doses of valganciclovir are equipotent for CMV universal prophylaxis. CMV 450 mg prophylaxis should be used for renal transplant recipients. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

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