Intrapatient Variability in Tacrolimus Trough Levels Over 2 Years Affects Long-Term Allograft Outcomes of Kidney Transplantation

This study aimed to determine the impact of tacrolimus (TAC) trough level (C0) intrapatient variability (IPV) over a period of 2 years after kidney transplantation (KT) on allograft outcomes. In total, 1,143 patients with low immunologic risk were enrolled. The time-weighted coefficient variability (TWCV) of TAC-C0 was calculated, and patients were divided into tertile groups (T1: < 24.6%, T2: 24.6%–33.7%, T3: ≥ 33.7%) according to TAC-C0-TWCV up to post-transplant 1st year. They were classified into the low/low, low/high, high/low, and high/high groups based on a TAC-C0-TWCV value of 33.7% during post-transplant 0–1st and 1st–2nd years. The allograft outcomes among the three tertile and four TAC-C0-TWCV groups were compared. The T3 group had the highest rate of death-censored allograft loss (DCGL), and T3 was considered an independent risk factor for DCGL. The low/low group had the lowest and the high/high group had the highest risk for DCGL. Moreover, patients with a mean TAC-C0 of ≥5 ng/ml in the high/high group were at the highest risk for DCGL. Thus, TAC-IPV can significantly affect allograft outcomes even with a high mean TAC-C0. Furthermore, to improve allograft outcomes, a low TAC-IPV should be maintained even after the first year of KT.

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Changes in recipient body mass index for the first year after kidney transplantation are associated with intrapatient variability of tacrolimus concentration and long-term graft function

Korean Journal of Transplantation ◽

10.4285/atw2020.or-1264 ◽

2020 ◽

Vol 34 (1) ◽

pp. S52-S52

Author(s):

Hyunmin Ko ◽

Chris Tae Young Chung ◽

Hyo Kee Kim ◽

Kwang Woo Choi ◽

Ahram Han ◽

...

Keyword(s):

Body Mass Index ◽

Kidney Transplantation ◽

Body Mass ◽

Graft Function ◽

Tacrolimus Concentration ◽

First Year ◽

Intrapatient Variability

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Long-Term Tacrolimus Blood Trough Level and Patient Survival in Adult Liver Transplantation

Journal of Personalized Medicine ◽

10.3390/jpm11020090 ◽

2021 ◽

Vol 11 (2) ◽

pp. 90

Author(s):

Chih-Yang Hsiao ◽

Ming-Chih Ho ◽

Cheng-Maw Ho ◽

Yao-Ming Wu ◽

Po-Huang Lee ◽

...

Keyword(s):

Patient Survival ◽

Trough Level ◽

Medical Center ◽

Term Survival ◽

Blood Concentrations ◽

Long Term Survival ◽

Tacrolimus Level ◽

Cox's Model ◽

The Impact

Tacrolimus is the most widely used immunosuppressant in liver transplant (LT) patients. However, the ideal long-term target level for these patients is unknown. This retrospective study aimed to investigate the impact of tacrolimus blood concentration five years after LT on long-term patient survival outcomes in adult LT recipients. Patients who underwent LT between January 2004 and July 2014 at a tertiary medical center were included in this study (n = 189). The mean tacrolimus blood concentrations of each patient during the fifth year after LT were recorded and the overall survival rate was determined. A multivariate analysis of factors associated with long-term survival was conducted using a Cox’s model. The median follow-up period was 9.63 years, and 144 patients (76.2%) underwent live donor LT. Sixteen patients died within 5 years of LT. In the Cox’s model, patients with a mean tacrolimus blood trough level of 4.6–10.2 ng/mL had significantly better long-term survival than those with a mean tacrolimus blood trough level outside this range (estimated hazard ratio = 4.76; 95% confidence interval: 1.34–16.9, p = 0.016). Therefore, a tacrolimus level no lower than 4.6 ng/mL would be recommended in adult LT patients.

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Progress in Pediatric Kidney Transplantation

The Open Urology & Nephrology Journal ◽

10.2174/1874303x014070100115 ◽

2014 ◽

Vol 7 (1) ◽

pp. 115-122

Author(s):

Jodi M. Smith ◽

Vikas R. Dharnidharka

Keyword(s):

Kidney Transplantation ◽

Graft Survival ◽

Pediatric Population ◽

Short Term ◽

Allocation Policy ◽

Pediatric Kidney Transplantation ◽

Timely Access ◽

The Impact ◽

Made In

Significant progress has been made in pediatric kidney transplantation. Advances in immunosuppression have dramatically decreased rates of acute rejection leading to improved short term graft survival but similar improvements in long term graft survival remain elusive. Changes in allocation policy provide the pediatric population with timely access to transplant but there remains concern about the impact of less HLA matching and a decrease in living donors. This report presents data from North America on these successes and the ongoing challenges that face the pediatric transplant community.

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First year of real-time VOC measurements at the SIRTA facility (Paris region, France): diurnal and seasonal variabilities, impact of lockdowns on air quality

10.5194/egusphere-egu21-8643 ◽

2021 ◽

Author(s):

Leïla Simon ◽

Valérie Gros ◽

Jean-Eudes Petit ◽

François Truong ◽

Roland Sarda-Esteve ◽

...

Keyword(s):

Air Quality ◽

Atmospheric Chemistry ◽

Seasonal Variability ◽

Anthropogenic Sources ◽

First Year ◽

Good Representation ◽

Atmospheric Measurements ◽

Paris Region ◽

The Impact

Volatile Organic Compounds (VOCs) have direct influences on air quality and climate. They also play a key role in atmospheric chemistry, as they are precursors of secondary pollutants, such as ozone (O3) and secondary organic aerosols (SOA).Long-term datasets of in-situ atmospheric measurements are crucial to characterize the variability of atmospheric chemical composition. Online and continuous measurements of O3, NOx and aerosols have been achieved at the SIRTA-ACTRIS facility (Paris region, France), since 2012. Regarding VOCs, they have been measured there for several years thanks to bi-weekly samplings followed by offline Gas Chromatography analysis. However, this method doesn&#8217;t provide a good representation of the temporal variability of VOC concentrations. To tackle this issue, online VOC measurements using a Proton-Transfer-Reaction Quadrupole Mass-Spectrometer (PTR-Q-MS) have been started in January 2020.The dataset acquired during the first year of online VOC measurements is analyzed, which gives insights on VOC seasonal variability. The additional long-term datasets obtained from co-located measurements (O3, NOx, aerosol physical and chemical properties, meteorological parameters) are also used for the sake of this study.Due to Covid-19 pandemic, the year 2020 notably comprised a total lockdown in France in Spring, and a lighter one in Autumn. Therefore, a focus can be made on the impact of these lockdowns on the VOC variability and sources. To this end, the diurnal cycles of VOCs considered markers for anthropogenic sources are carefully investigated. Results notably indicate that markers for traffic and wood burning sources behave quite differently during the Spring lockdown in comparison to the other periods. A source apportionment analysis using positive matrix factorization allows to further document the seasonal variability of VOC sources and the impacts on air quality associated with the lockdown measures.

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Long-term Clinical Significance of Tacrolimus Trough Level at the Early Period After Kidney Transplantation

Transplantation Proceedings ◽

10.1016/j.transproceed.2019.03.065 ◽

2019 ◽

Vol 51 (8) ◽

pp. 2643-2647 ◽

Cited By ~ 1

Author(s):

Woo Yeong Park ◽

Jin Hyuk Paek ◽

Kyubok Jin ◽

Sung Bae Park ◽

Seungyeup Han

Keyword(s):

Kidney Transplantation ◽

Clinical Significance ◽

Trough Level ◽

Early Period

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National Evidence of the Impact of First-Year Online Enrollment on Postsecondary Students’ Long-Term Academic Outcomes

Research in Higher Education ◽

10.1007/s11162-018-9495-1 ◽

2018 ◽

Vol 59 (8) ◽

pp. 1035-1058 ◽

Cited By ~ 4

Author(s):

Justin C. Ortagus

Keyword(s):

Academic Outcomes ◽

First Year ◽

Postsecondary Students ◽

The Impact

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“Trump’s First Year in Asia: Accelerating a Long-term Trend”

Journal of American-East Asian Relations ◽

10.1163/18765610-02502002 ◽

2018 ◽

Vol 25 (2) ◽

pp. 198-220 ◽

Cited By ~ 1

Author(s):

David C. Kang

Keyword(s):

East Asia ◽

The United States ◽

First Year ◽

Foreseeable Future ◽

Real Possibility ◽

Term Trend ◽

Trade War ◽

The Impact ◽

Long Term Trend

What has been the impact of Donald J. Trump’s presidency on the place of the United States in East Asia? Trump already has shown a proclivity for upending the mainstream American consensus about grand strategy to East Asia, with the real possibility of a trade war with China or a shooting war with North Korea on the horizon. However, this article will place President Trump’s first year in office into a larger context of long-term decline of U.S. leadership and influence in East Asia, arguing that this trend has been underway for quite some time, and that Trump has not altered fundamentally this trajectory. Some of Trump’s actions may accelerate a decline in U.S. leadership, but by no means was Trump the first nor will he be the last U.S. president to deal with a swiftly changing East Asia. The region has been changing rapidly for decades, and there are no indications that this will stop anytime soon. However, continuing and gradual U.S. withdrawal from leadership does not mean less American-East Asia interaction. East Asia will remain the most important trading and investment region for the U.S. for the foreseeable future.

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P1731ABO INCOMPATIBLE DONOR KIDNEY TRANSPLANTATION IN PORTUGAL

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1731 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Natalia Silva ◽

Catarina Isabel Ribeiro ◽

Jorge Malheiro ◽

Manuela Almeida ◽

Sofia Pedroso ◽

...

Keyword(s):

Kidney Transplantation ◽

Infectious Complications ◽

Long Term Results ◽

First Year ◽

Donor Pool ◽

Bk Polyomavirus ◽

Effective Therapeutic Strategy ◽

Immunosuppressive Protocol ◽

And Function

Abstract Background and Aims ABO incompatiblitity was considered a barrier to kidney transplant. However, the shortage of available organs for transplantation and the excellent long term results further establish ABO-incompatible (ABOi) as a safe and effective therapeutic strategy. The aim of the present study was to evaluate the outcomes of ABOi transplantation in terms of graft survival and function, rejection episodes and infections complications. Method The authors present a single center retrospective observational study, that include the analyse of 12 patients who underwent ABOi kidney transplantation between November 2014 and July 2019. All patients received Rituximab (375mg/m2) pre-operation and started Tacrolimus, Mycophenolate Mofetil and Prednisolone one week before surgery. Plasmapheresis was done to remove anti-A or B antibodies until their titles were <1:8 during the first post-operative week and <1:16 at the second. Results : A total of 12 patients were included in the study, 75,0% male with 43 years (IQR 31-50) The most common blood group mismatch was A to O (n=4; 33%). In the first year, 2 of patients (17%) developed acute rejection. The follow-up time was 17 months (IQR 7-36). Five patients (42%) developed infectious complications. None patients developed cytomegalovirus or BK polyomavirus infections. At the end graft and patient survival were 100%. Conclusion ABOi kidney transplantation has become a routine procedure. By this approach, about 30% of living donors who were refused in the past can now donate their kidneys and thereby significantly expand the living donor pool. Immunosuppressive protocol of this Center can be considered safe.

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