Earticle

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

키워드

저자

• 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 ] Co-correspondence
• 최영록 [ YoungRok Choi | 서울대학교병원 외과 ] Corresponding Author

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  한국임상약학회지 [Korean Journal of Clinical Pharmacy]

• 간기

  계간

• pISSN

  1226-6051

• 수록기간

  1991~2026

• 등재여부

  KCI 등재

• 십진분류

  KDC 518 DDC 615