Tacrolimus intra-patient variability in pediatric liver transplantation

doi:10.16139/j.1007-9610.2022.02.012

Abstract

Abstract:

Objective To study tacrolimus intra-patient variability (Tac-IPV) after liver transplantation in children and the influence on prognosis of transplantation. Methods A total of 392 pediatric liver transplant recipients were included in this single-center retrospective study. All children were treated with Tac-based immunosuppressive therapy postoperatively. Tac-IPV was calculated using both coefficient of variation (CV) and Tac variability score (TVS) methods. According to both follow-up and biopsy results, the difference in IPV was analyzed between complication group and normal recovery group. The influence of IPV on postoperative complications after transplantation were analyzed using two calculation methods. Results There were 175 males and 217 females with(24.73±36.58) months of age when transplantation included in this study. After pediatric liver transplantation, the median Tac-CV was 0.386 3, 0.317 0, and 0.291 3 in the first three years respectively, and 0.296 1 in 4-5 years. There was no significant difference in IPV calculated by CV between complication group and normal recovery group, such as rejection and liver fibrosis. However, the difference in IPV was significant statistically calculated by TVS within 1-12 months (P=0.011) and 4-12 months (P=0.001) between postoperative liver fibrosis group and normal recovery group. Conclusions After pediatric liver transplantation, Tac-IPV decreased in the first 3 years. Increase in Tac-IPV may be associated with poorer clinical outcomes such as liver fibrosis.

Key words: Tacrolimus, Intra-patient variability, Liver transplantation

CLC Number:

R657.3

WU Haoxiang, LÜ Zicheng, HOU Yuchen, ZHANG Zijie, QIAO Ziyun, FENG Hao, XIA Qiang. Tacrolimus intra-patient variability in pediatric liver transplantation[J]. Journal of Surgery Concepts & Practice, 2022, 27(02): 145-151.

Figures/Tables 4

References 30

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项目	类别	值
性别	男性	175（44.64）
	女性	217（55.36）
移植时月龄（月）	/	24.73±36.58
体重（kg）	/	10.57±7.89
诊断	胆道闭锁	325（82.91）
	代谢性疾病	23（5.87）
	肿瘤	2（0.51）
	其他	42（10.71）
手术类型	LDLT	288（73.47）
	DCD	104（26.53）
GRWR	/	3.31±1.15
免疫抑制方案	Tac	11（2.81）
	Tac+GC	95（24.23）
	Tac+MMF	15（3.83）
	Tac+GC+MMF	271（69.13）