Cited 3 times in
Clinical association between tacrolimus intra-patient variability and liver transplantation outcomes in patients with and without hepatocellular carcinoma
DC Field | Value | Language |
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dc.contributor.author | 이재근 | - |
dc.contributor.author | 이주한 | - |
dc.contributor.author | 주동진 | - |
dc.contributor.author | 김명수 | - |
dc.contributor.author | 김현정 | - |
dc.date.accessioned | 2022-12-22T04:18:52Z | - |
dc.date.available | 2022-12-22T04:18:52Z | - |
dc.date.issued | 2022-09 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/192102 | - |
dc.description.abstract | Tacrolimus is the mainstay of immunosuppression in liver transplantation to prevent rejection. However, the clinical use of tacrolimus is complicated by its narrow therapeutic window and significant intra-patient variability (IPV). High tacrolimus IPV is associated with overexposure and adverse effects, including malignancy. The effects of tacrolimus IPV in liver transplant recipients with and without hepatocellular carcinoma (HCC) are unknown. We investigated the association between tacrolimus IPV and transplant outcomes in 636 liver transplant patients. Tacrolimus IPV was determined by calculating the coefficient of variance (CV) of outpatient tacrolimus trough levels from 3 to 12 months after transplantation. High tacrolimus IPV was defined as CV > 30%. Patients were grouped according to tacrolimus IPV and HCC status. Among 636 liver transplant patients, 349 had HCC and 287 had no HCC. Overall survival in HCC patients was significantly reduced with high tacrolimus IPV (P < 0.001), whereas survival of non-HCC patients was not associated with tacrolimus IPV. Multivariable analysis confirmed the independent association between high tacrolimus IPV and overall mortality in HCC patients (HR, 3.010; 95% CI, 1.084-4.918). HCC recurred in 59 patients (16.9%) post-transplantation. After adjusting for donor/recipient factors, immunosuppression, and tumor characteristics, high tacrolimus IPV was independently associated with an increased risk of HCC recurrence (HR, 2.196; 95% CI, 1.272-3.791). High tacrolimus IPV was associated with significantly increased risks of overall mortality and HCC recurrence in liver transplant recipients with HCC. | - |
dc.description.statementOfResponsibility | open | - |
dc.format | application/pdf | - |
dc.language | English | - |
dc.publisher | Nature Publishing Group | - |
dc.relation.isPartOf | SCIENTIFIC REPORTS | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Carcinoma, Hepatocellular* / drug therapy | - |
dc.subject.MESH | Graft Rejection / etiology | - |
dc.subject.MESH | Graft Survival | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Immunosuppressive Agents / adverse effects | - |
dc.subject.MESH | Liver Neoplasms* / drug therapy | - |
dc.subject.MESH | Liver Transplantation* / adverse effects | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Risk Factors | - |
dc.subject.MESH | Tacrolimus / adverse effects | - |
dc.title | Clinical association between tacrolimus intra-patient variability and liver transplantation outcomes in patients with and without hepatocellular carcinoma | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Surgery (외과학교실) | - |
dc.contributor.googleauthor | Hyun Jeong Kim | - |
dc.contributor.googleauthor | Juhan Lee | - |
dc.contributor.googleauthor | Jae Geun Lee | - |
dc.contributor.googleauthor | Dong Jin Joo | - |
dc.contributor.googleauthor | Myoung Soo Kim | - |
dc.identifier.doi | 10.1038/s41598-022-20636-3 | - |
dc.contributor.localId | A03068 | - |
dc.contributor.localId | A03163 | - |
dc.contributor.localId | A03948 | - |
dc.contributor.localId | A00424 | - |
dc.relation.journalcode | J02646 | - |
dc.identifier.eissn | 2045-2322 | - |
dc.identifier.pmid | 36171260 | - |
dc.contributor.alternativeName | Lee, Jae Geun | - |
dc.contributor.affiliatedAuthor | 이재근 | - |
dc.contributor.affiliatedAuthor | 이주한 | - |
dc.contributor.affiliatedAuthor | 주동진 | - |
dc.contributor.affiliatedAuthor | 김명수 | - |
dc.citation.volume | 12 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 16169 | - |
dc.identifier.bibliographicCitation | SCIENTIFIC REPORTS, Vol.12(1) : 16169, 2022-09 | - |
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