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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