Correlation of Tough Tacrolimus Level with Early Acute Rejections in Renal Allograft Recipients- A Prospective Study

Volume 1 - Issue 3

Manish Tripathi*, Kalpesh Gohel, Umapati Hegde, Sishir Gang and Mohan Rajapurkar

Received: January 03, 2018;   Published: January 18, 2018

DOI: 10.32474/IGWHC.2018.01.000111

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Abstract

Acute Rejection is the key mediators of long term graft loss. So we aimed the present study to assess the correlation of baseline pre transplant trough tacrolimus level with early rejection. We prospectively analyzed the trough tacrolimus level on the day prior to transplantation of 179 patients transplanted from September 2007 to September 2009. We divided them into three groups according to the trough levels: Group I = < 5 ng/ml, Group II = 5-15 ng/ml and Group III = > 15ng/ml. Their demography, incidence of BPAR, NOD, infections and biopsy proven CNI toxicity were studied. Incidence of BPAR were the highest in the Group I and lowest in the Group III. None of the patients in Group III had rejection with Banff grade > 2. Incidences of post transplant at infection, new onset diabetes were comparable. Trend towards higher incidence of biopsy proven CNI toxicity was noted from Group I to Group III. These results indicate that the incidence as well as severity of early rejection reduces as the pre transplant trough tacrolimus level increases. Trend towards higher nephrotoxicity with higher trough level was noted [1-25].

Keywords: Acute rejection; Renal transplant; Pre transplant tough; Tacrolimus level; Live donors; Graft survival; Nephrotoxicity

Abbrevations: BPAR: Biopsy Proven Acute Rejection; NOD: New Onset Diabetes; CNI: Calcineurin Inhibitor; MMF: Mycophenolate Mofetil; WIT: Warm Ischemia Time; CIT: Cold Ischemia Time; PTDM: Post Transplant Diabetes Mellitus; TAC: Tacrolimus; DGF: Delayed Graft Function; OHA: Oral Hypoglycemic Agent; TMA: Thrombotic Microangiopathy; TRAS: Transplant Renal Artery Stenosis; AGE: Acute Gastroenteritis; CMV: Cytomegalo Virus; HBV: Hepatitis B Virus; HCV: Hepatitis C Virus; UTI: Urinary Tract Infection; TCMR: T Cell Mediated Rejection; AMR: Antibody Mediated Rejection; TIR: Tubulo Interstitial Rejection

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