Interleukin-2 receptor antibody induction with early low dose tacrolimus preserves post-liver transplant renal function in at risk individuals - 23/12/21
: Conceptualization Formal analysis Data curation Writing – original draft Writing – review & editing
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Abstract |
Background |
Renal dysfunction post liver transplantation (LT) is common. We report our real-world experience of IL2Ra induction with immediate exposure to reduced dose tacrolimus used for patients with chronic kidney disease (CKD) and evolving acute kidney injury (AKI).
Method |
A single-centre retrospective analysis of elective adult LT from 1/1/17 to 31/12/17. The primary outcome measure was increase in CKD stage at month 6 post-LT, and secondary outcome was early biopsy proven acute rejection (BPAR).
Results |
161 patients were included: 17 planned-IL2Ra for CKD; 38 unplanned-IL2Ra for AKI; and 106 standard immunosuppression. IL2Ra group had lower trough tacrolimus levels till month 3 post-LT. Patients receiving IL2Ra did not have an increased risk of increase in CKD class at month 6 (aOR 0.95, 95% CI 0.34–2.75, P = 0.92), or of early BPAR (aOR 0.53, 95% CI 0.19–1.32, P = 0.19).
Conclusion |
IL2Ra induction with immediate exposure to reduced dose tacrolimus can be given to patients with CKD or early evolving AKI post-LT, with no greater attrition of renal function at 6 months or an increased risk of early BPAR when compared to standard IS. Longer-term outcome data is required, however this regimen can be considered for high risk LT recipients with CKD and AKI.
Le texte complet de cet article est disponible en PDF.Keywords : Immunosuppression, Tacrolimus, Chronic kidney disease, Cellular rejection, Basiliximab
Abbreviations : AKI, AST, BPAR, CKD, CNI, DCD, EAD, eGFR, HCC, IL2Ra, INR, IS, ITU, LT, MELD, MMF, NAFLD, PNF, RRT, UKELD, uPCR
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Vol 3
Article 100028- juillet 2021 Retour au numéro
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