earticle

논문검색

Original Article

Tacrolimus의 혈중농도 변동성이 간이식 예후에 미치는 영향

원문정보

The Effects of Intrapatient Variability in Tacrolimus Concentration on Clinical Outcomes Immediately After Liver Transplantation

김은지, 김보람, 조정원, 이정화, 이은숙, 유윤미, 조재영, 김은경, 최영록

피인용수 : 0(자료제공 : 네이버학술정보)

초록

영어

Background: Tacrolimus, a calcineurin inhibitor, is an immunosuppressant used in post-transplantation maintenance therapy. The drug has a narrow therapeutic range and requires periodic therapeutic drug monitoring. Although many studies have reported the effects of intrapatient variability of tacrolimus on survival, rejection, and complications in renal transplant recipients, very few studies have reported these effects in liver transplant recipients. The purpose of this study was to evaluate the effect of intrapatient variability of tacrolimus on clinical outcomes after liver transplantation. Methods: Intrapatient variability was calculated using individual, averaged tacrolimus concentrations. Patients were divided into two groups according to their median variability value: high-variability and low-variability groups. The rate of deviation from the therapeutic range, incidence of acute rejection, posttransplant diabetes, incidence of infection, and estimated glomerular filtration rate (eGFR) after transplantation were compared between the groups. Results: Of the total patients (n=82), the high-variability group (n=41) exhibited significantly greater deviation from the therapeutic range (65.92% vs. 56.84%; p<0.001). There was no significant difference in acute rejection or posttransplantation diabetes incidence or eGFR; however, the number of infection in the first 6 months was significantly lower in the low-variability group (0.4 vs. 0.9 times; p=0.039). Multiple linear regression analysis showed that the number of infection significantly increased as intrapatient variability increased (p=0.015). Conclusion: High intrapatient variability in tacrolimus concentrations was strongly associated with an increased frequency of deviation from the suggested therapeutic range and an increased number of infection.

목차

ABSTRACT
Methods
Patient selection
Medical care after liver transplantation
Tacrolimus IPV calculation
Outcome
Statistics
Results
Serum tacrolimus trough level
Acute rejection, infection, and post-transplant diabetes
Renal function
Discussion
Declaration of Conflicting interest
References

저자정보

  • 김은지 Eunji Kim. 분당서울대학교병원 약제부
  • 김보람 Boram Kim. 분당서울대학교병원 약제부
  • 조정원 Jungwon Cho. 분당서울대학교병원 약제부
  • 이정화 Jung Hwa Lee. 분당서울대학교병원 약제부
  • 이은숙 Eunsook Lee. 분당서울대학교병원 약제부
  • 유윤미 Yun Mi Yu. 연세대학교 약학대학
  • 조재영 Jai Young Cho. 분당서울대학교병원 외과
  • 김은경 Euni Lee. 서울대학교 약학대학
  • 최영록 YoungRok Choi. 서울대학교병원 외과

참고문헌

자료제공 : 네이버학술정보

    함께 이용한 논문

      ※ 기관로그인 시 무료 이용이 가능합니다.

      • 4,000원

      0개의 논문이 장바구니에 담겼습니다.