PMID- 26281147
OWN - NLM
STAT- MEDLINE
DCOM- 20150908
LR  - 20151119
IS  - 0890-9016 (Print)
IS  - 0890-9016 (Linking)
DP  - 2014
TI  - Higher Serum Trough Levels of Tacrolimus Increase 5-Year Allograft Survival in 
      Antibody Positive Renal Transplant Patients.
PG  - 209-14
AB  - BACKGROUND: The presence of human leukocyte antigen (HLA) and major 
      histocompatibility complex class I chain-related gene-A (MICA) antibodies after 
      transplantation is correlated with rejection episodes, proteinuria, and renal 
      allografts loss. We assessed the clinical value of high-dose tacrolimus on 
      post-transplant HLA and MICA antibodies and proteinuria after renal 
      transplantation. METHODS: Post-transplant sera of 310 renal transplantation 
      patients who were negative for antibodies prior to transplant were tested by 
      Luminex flow cytometry for HLA antibodies and MICA antibodies posttransplant. 
      Once a patient was found to be antibody positive (Ab+), tacrolimus was dosed at 
      two different concentrations: high tacrolimus Ab+ group (11 +/- 1.36 ng/mL average 
      tacrolimus trough) or low tacrolimus Ab+ group (7 +/- 1.28 ng/mL average tacrolimus 
      trough). Antibody negative (Ab-) patients were also studied and were given 
      comparable tacrolimus doses to the low tacrolimus Ab+ group (7 +/- 1.28 ng/mL 
      average tacrolimus trough). Proteinuria was measured using the pyrogallol method. 
      All patients were followed for 5 years after renal transplantation. Associations 
      between tacrolimus, proteinuria, and survival were analyzed. RESULTS: In the HLA 
      or MICA Ab+ patients, proteinuria decreased after 5 years in the high tacrolimus 
      Ab+ group unlike the low tacrolimus Ab+ group. Allograft survival in the high 
      tacrolimus Ab+ group was significantly higher than the low tacrolimus Ab+ group 
      and was similar to that of the Ab- group. CONCLUSIONS: High-dose tacrolimus might 
      play a role in improving allograft survival in HLA or MICA Ab+ post-transplant 
      patients. Increasing tacrolimus concentration might be a plausible treatment for 
      Ab+ post-transplant patients.
FAU - Peng, Zhi-Guo
AU  - Peng ZG
FAU - Tian, Jun
AU  - Tian J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Transpl
JT  - Clinical transplants
JID - 8812419
RN  - 0 (Biomarkers)
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Biomarkers/blood
MH  - Calcineurin Inhibitors/*blood/pharmacokinetics
MH  - Drug Monitoring
MH  - Drug Therapy, Combination
MH  - Female
MH  - Graft Rejection/blood/immunology/*prevention & control
MH  - Graft Survival/*drug effects
MH  - HLA Antigens/*blood
MH  - *Histocompatibility
MH  - Humans
MH  - Immunosuppressive Agents/*blood/pharmacokinetics
MH  - Isoantibodies/*blood
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Immunologic
MH  - Predictive Value of Tests
MH  - Proteinuria/immunology/prevention & control
MH  - Tacrolimus/*blood/pharmacokinetics
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2014/01/01 00:00
MHDA- 2015/09/09 06:00
CRDT- 2015/08/19 06:00
PHST- 2015/08/19 06:00 [entrez]
PHST- 2014/01/01 00:00 [pubmed]
PHST- 2015/09/09 06:00 [medline]
PST - ppublish
SO  - Clin Transpl. 2014:209-14.