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Association of tacrolimus time-to-therapeutic range on renal dysfunction and acute cellular rejection after orthotopic heart transplantation in a high use basiliximab population.

Publication ,  Journal Article
Nanni, AN; Harris, M; Watson, M; Yang, Z; Lee, H-J; DeVore, AD; Henderson, JB
Published in: Clin Transplant
March 2022

BACKGROUND: Currently, clinicians often delay initiation of tacrolimus after orthotopic heart transplantation (OHT) to help mitigate nephrotoxicity. This study aimed to determine if there is an association between the time-to-therapeutic range (TTT) of tacrolimus, early renal dysfunction, and acute cellular rejection (ACR) after OHT. METHODS: This was a retrospective, single center study with adult patients who underwent OHT from July 2013 to April 2020. Logistic regression analysis was utilized to examine the association of TTT with new renal dysfunction after tacrolimus initiation post-OHT. RESULTS: In a study of 317 patients, the unadjusted analysis showed patients who developed new renal dysfunction after tacrolimus initiation had a numerically shorter TTT (9.5 vs. 11.0 days, P = .065), and were more likely to have supratherapeutic tacrolimus levels (56% vs. 39.2%, P = .010). When adjusted for established risk factors for renal dysfunction, TTT was significantly associated with new renal dysfunction (OR .95; 95% CI [.90, .99], P = .03). There was no association between TTT and the incidence of ACR (11.1 vs. 10.8 days, P = .64). CONCLUSION: When adjusting for known risk factors, a shorter TTT was associated with new renal dysfunction. Supratherapeutic tacrolimus levels were also associated with new renal dysfunction. There was no association between TTT and ACR in the setting of high use basiliximab induction.

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Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

March 2022

Volume

36

Issue

3

Start / End Page

e14542

Location

Denmark

Related Subject Headings

  • Tacrolimus
  • Surgery
  • Retrospective Studies
  • Renal Insufficiency
  • Male
  • Immunosuppressive Agents
  • Humans
  • Heart Transplantation
  • Graft Rejection
  • Female
 

Citation

APA
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ICMJE
MLA
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Nanni, A. N., Harris, M., Watson, M., Yang, Z., Lee, H.-J., DeVore, A. D., & Henderson, J. B. (2022). Association of tacrolimus time-to-therapeutic range on renal dysfunction and acute cellular rejection after orthotopic heart transplantation in a high use basiliximab population. Clin Transplant, 36(3), e14542. https://doi.org/10.1111/ctr.14542
Nanni, Alexis N., Matthew Harris, Mara Watson, Zidanyue Yang, Hui-Jie Lee, Adam D. DeVore, and James B. Henderson. “Association of tacrolimus time-to-therapeutic range on renal dysfunction and acute cellular rejection after orthotopic heart transplantation in a high use basiliximab population.Clin Transplant 36, no. 3 (March 2022): e14542. https://doi.org/10.1111/ctr.14542.
Journal cover image

Published In

Clin Transplant

DOI

EISSN

1399-0012

Publication Date

March 2022

Volume

36

Issue

3

Start / End Page

e14542

Location

Denmark

Related Subject Headings

  • Tacrolimus
  • Surgery
  • Retrospective Studies
  • Renal Insufficiency
  • Male
  • Immunosuppressive Agents
  • Humans
  • Heart Transplantation
  • Graft Rejection
  • Female