The Effect of Donor Age and Recipient Characteristics on Renal Outcomes in Patients Receiving Prolonged-Release Tacrolimus After Liver Transplantation : Post-Hoc Analyses of the DIAMOND Study

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DIAMOND Study Grp , Trunecka , P , Klempnauer , J , Bechstein , W O , Isoniemi , H & Tisone , G 2019 , ' The Effect of Donor Age and Recipient Characteristics on Renal Outcomes in Patients Receiving Prolonged-Release Tacrolimus After Liver Transplantation : Post-Hoc Analyses of the DIAMOND Study ' , Annals of transplantation , vol. 24 , pp. 319-327 . https://doi.org/10.12659/AOT.913103

Title: The Effect of Donor Age and Recipient Characteristics on Renal Outcomes in Patients Receiving Prolonged-Release Tacrolimus After Liver Transplantation : Post-Hoc Analyses of the DIAMOND Study
Author: DIAMOND Study Grp; Trunecka, Pavel; Klempnauer, Juergen; Bechstein, Wolf Otto; Isoniemi, Helena; Tisone, Giuseppe
Contributor organization: HUS Abdominal Center
IV kirurgian klinikka
Date: 2019-06-04
Language: eng
Number of pages: 9
Belongs to series: Annals of transplantation
ISSN: 1425-9524
DOI: https://doi.org/10.12659/AOT.913103
URI: http://hdl.handle.net/10138/305159
Abstract: Background: The DIAMOND study of de novo liver transplant patients showed that prolonged-release tacrolimus exposure in the acute post-transplant period maintained renal function over 24 weeks of treatment. To assess these findings further, we performed a post-hoc analysis in patients according to baseline kidney function, Model for End-stage Liver Disease [MELD] scores, and donor age. Material/Methods: Patients received prolonged-release tacrolimus (initial-dose, Arm 1: 0.2 mg/kg/day, Arm 2: 0.15-0.175 mg/kg/day, Arm 3: 0.2 mg/kg/day delayed until Day 5), mycophenolate mofetil and 1 steroid bolus. Arms 2 and 3 also received basiliximab. The recommended tacrolimus target trough levels to Day 42 post-transplantation were 5-15 ng/mL in all arms. In this post-hoc analysis, change in renal outcome, based on estimated glomerular filtration rate (eGFR), Modified Diet in Renal Disease-4 (MDRD4), values from baseline to Week 24 post-transplantation, were assessed according to baseline patient factors: eGFR (>= 60 and = 25) and donor age (= 50 years). Results: Baseline characteristics were comparable (Arms 1-3: n=283, n=287, n=274, respectively). Patients with baseline renal function, eGFR >= 60 mL/min/1.73 m(2), experienced a decrease in eGFR in all tacrolimus treatment arms. In patients with lower baseline renal function (eGFR Conclusions: Pre-transplantation factors, such as renal function and donor age, could guide the choice of prolonged-release tacrolimus regimen following liver transplantation.
Subject: Glomerular Filtration Rate
Immunosuppressive Agents
Liver Transplantation
Tacrolimus
ACUTE KIDNEY INJURY
RISK-FACTORS
DYSFUNCTION
FAILURE
MORTALITY
MELD
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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