Conference Proceeding

Correlation of Pretransplant Trough Tacrolimus Level with Early Acute Rejection in Live Donor Renal Transplantation

Dr Manish Tripathi,
Specialist Nephrologist, Amina Hospital, UAE

Dr.Manish Possess 14 years of work experience at premier institutes in India, including 3.3 years with GMC Hospital and Research center, Ajman, UAE as Specialist Nephrologist. Functional in establishing Nephrology department and acquiring JCI accredition to the hospital. His Core capabilities include:

  • Managing & providing continuity of care to patients with kidney-related illness or disease
  • Pre-transplant evaluation and post-transplant medical management & follow up
  • Dialysis (hemo & peritoneal dialysis) procedures in patients with acute and chronic renal problems
  • Familiar with S.L.E.D (Slow low-efficiency dialysis) to manage acute kidney injury
  • I.C.U and post-surgical patients with renal problems
  • Procedures including:
  1. Percutaneous native & transplant kidney biopsies
  2. Placement of temporary vascular access catheters
  3. Percutaneous CAPD catheter insertion

Introduction and Aim: 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.
Methods: 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.
Results: All groups were comparable as shown in Table 1. 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.
Conclusion: 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.

Published: 28 April 2017