Current Topics in TransplantationRenal transplantationImpact of Trough Levels of Tacrolimus on Kidney Function and Graft Survival in Short and Longer Periods After Renal Transplantation

- The highest incidence of acute rejection was observed in the first post-transplant year most frequent occurrence of acute rejection was in the cyclosporine group.
- The average TAC levels on elapsed time after transplantation significantly decreased.
- Five years after renal transplantation, there were higher TAC levels in the group with “zero” low levels than in the group with “zero” high levels.
- We did not find any differences between TAC levels and groups according to the induction therapy.
- We did not find any difference in graft and patient survival at posttransplant years 2 and 5.

BackgroundOptimizing immunosuppressive treatment in the early posttransplant period is important for achieving long-term graft function and survival.Material and MethodsThere were 205 renal transplant recipients involved in this study. Patients were divided into groups according to the induction therapy (no induction vs basiliximab/daclizumab vs rabbit antithymocyte globulin), maintenance therapy at the time of transplantation (tacrolimus [TAC] vs cyclosporine), the average trough TAC levels in months 4 to 6 after TO and serum creatinine 5 years after renal transplantation.ResultsThe incidence of acute rejection was significantly higher in cyclosporine than in TAC group of patients (P = .0364). The average TAC levels on elapsed time after transplantation significantly decreased (P < .0001). Five years after renal transplantation, there were higher TAC levels (5.6 ± 0.7 ng/mL) in the group with “zero” low levels than in the group with “zero” high levels (4.6 ± 1.1 ng/mL), which was statistically significant (P < .0001). We did not find any difference in graft and patient survival in posttransplant years 2 to 5 according to TAC levels or the induction treatment.ConclusionsIn our study, we have confirmed that better graft function 5 years after transplantation was connected with higher trough tacrolimus levels on elapsed time after renal transplantation.