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Tacrolimus trough levels higher than 6 ng/mL might not be required after a year in stable kidney transplant recipients
DC Field | Value | Language |
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dc.contributor.author | 허규하 | - |
dc.date.accessioned | 2021-05-21T16:59:47Z | - |
dc.date.available | 2021-05-21T16:59:47Z | - |
dc.date.issued | 2020-07 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/182649 | - |
dc.description.abstract | Background: Little is known regarding optimal tacrolimus (TAC) trough levels after 1 year post-transplant in stable kidney transplant recipients (KTRs) who have not experienced renal or cardiovascular outcomes. This study aimed to investigate the effect of 1-year post-transplant TAC trough levels on long-term renal and cardiovascular outcomes and opportunistic infections in stable KTRs. Methods: KTRs receiving TAC with mycophenolate-based immunosuppression who did not experience renal or cardiovascular outcomes within 1 year post-transplant were enrolled from a multicenter observational cohort study. Renal outcome was defined as a composite of biopsy-proven acute rejection, interstitial fibrosis and tubular atrophy, and death-censored graft loss. Cardiovascular outcome was defined as a composite of de novo cardiomegaly, left ventricular hypertrophy, and cardiovascular events. Opportunistic infections were defined as the occurrence of BK virus or cytomegalovirus infections. Results: A total of 603 eligible KTRs were divided into the low-level TAC (LL-TAC) and high-level TAC (HL-TAC) groups based on a median TAC level of 5.9 ng/mL (range 1.3-14.3) at 1 year post-transplant. The HL-TAC group had significantly higher TAC trough levels at 2, 3, 4, and 5 years compared with the levels of the LL-TAC group. During the mean follow-up of 63.7 ± 13.0 months, there were 121 renal outcomes and 224 cardiovascular outcomes. In multivariate Cox regression analysis, LL-TAC and HL-TAC were not independent risk factors for renal and cardiovascular outcomes, respectively. No significant differences in the development of opportunistic infections and de novo donor-specific anti-human leukocyte antigen antibodies and renal allograft function were observed between the two groups. Conclusions: TAC trough levels after 1 year post-transplant remained at a similar level until the fifth year after kidney transplantation and were not directly associated with long-term outcomes in stable Korean KTRs who did not experience renal or cardiovascular outcomes. Therefore, in Asian KTRs with a stable clinical course, TAC trough levels higher than approximately 6 ng/mL might not be required after a year of kidney transplantation. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | Public Library of Science | - |
dc.relation.isPartOf | PLOS ONE | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Cardiovascular Diseases / chemically induced | - |
dc.subject.MESH | Cohort Studies | - |
dc.subject.MESH | Cytomegalovirus Infections / chemically induced | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Graft Rejection / chemically induced | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Immunosuppression / adverse effects* | - |
dc.subject.MESH | Immunosuppressive Agents* / administration & dosage | - |
dc.subject.MESH | Immunosuppressive Agents* / adverse effects | - |
dc.subject.MESH | Immunosuppressive Agents* / blood | - |
dc.subject.MESH | Kidney Transplantation / rehabilitation* | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Opportunistic Infections / chemically induced | - |
dc.subject.MESH | Polyomavirus Infections / chemically induced | - |
dc.subject.MESH | Renal Insufficiency / chemically induced | - |
dc.subject.MESH | Republic of Korea | - |
dc.subject.MESH | Tacrolimus* / administration & dosage | - |
dc.subject.MESH | Tacrolimus* / adverse effects | - |
dc.subject.MESH | Tacrolimus* / blood | - |
dc.title | Tacrolimus trough levels higher than 6 ng/mL might not be required after a year in stable kidney transplant recipients | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Surgery (외과학교실) | - |
dc.contributor.googleauthor | Hee-Yeon Jung | - |
dc.contributor.googleauthor | Min Young Seo | - |
dc.contributor.googleauthor | Yena Jeon | - |
dc.contributor.googleauthor | Kyu Ha Huh | - |
dc.contributor.googleauthor | Jae Berm Park | - |
dc.contributor.googleauthor | Cheol Woong Jung | - |
dc.contributor.googleauthor | Sik Lee | - |
dc.contributor.googleauthor | Seung-Yeup Han | - |
dc.contributor.googleauthor | Han Ro | - |
dc.contributor.googleauthor | Jaeseok Yang | - |
dc.contributor.googleauthor | Curie Ahn | - |
dc.contributor.googleauthor | Ji-Young Choi | - |
dc.contributor.googleauthor | Jang-Hee Cho | - |
dc.contributor.googleauthor | , Sun-Hee Park | - |
dc.contributor.googleauthor | Yong-Lim Kim | - |
dc.contributor.googleauthor | Chan-Duck Kim | - |
dc.identifier.doi | 10.1371/journal.pone.0235418 | - |
dc.contributor.localId | A04344 | - |
dc.relation.journalcode | J02540 | - |
dc.identifier.eissn | 1932-6203 | - |
dc.identifier.pmid | 32614859 | - |
dc.contributor.alternativeName | Huh, Kyu Ha | - |
dc.contributor.affiliatedAuthor | 허규하 | - |
dc.citation.volume | 15 | - |
dc.citation.number | 7 | - |
dc.citation.startPage | e0235418 | - |
dc.identifier.bibliographicCitation | PLOS ONE, Vol.15(7) : e0235418, 2020-07 | - |
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