Scholarlink

Background <p>BK virus (BKV) infection is a significant complication in kidney transplant recipients, potentially leading to graft loss. The relationship between pre-transplant tacrolimus (TAC) pharmacokinetics and BKV infection risk remains unclear. This study aimed to investigate whether pre-transplant TAC blood concentration fluctuations are associated with BKV infection risk.</p> Methods <p>We conducted a retrospective study of 135 living donor kidney transplant recipients at Hirosaki University between 2006 and March 2024. Patients were divided into BKV-infected (BKV) and non-infected (non-BKV) groups. TAC blood concentrations were measured at 4 points, including 0 h (2 h before TAC administration), 4, 6, and 12 h on the day before transplantation. Changes in TAC concentration from baseline (0&#xa0;h) were calculated for each time point. The concentration/dose (C0/D) ratio was used as an indicator of TAC metabolism rate.</p> Results <p>During a median follow-up of 54&#xa0;months, 29 recipients developed BKV infection. The BKV group had significantly older donors and showed a significantly larger decrease in TAC concentration at 12&#xa0;h compared to the non-BKV group (-1.5 vs. 0&#xa0;ng/mL, P = 0.008). There was no significant difference in pre-transplant C0/D ratios between the two groups. A decrease of ≥ 1.5&#xa0;ng/mL at 12&#xa0;h was identified as a significant risk factor for BKV infection (hazard ratio: 2.44, 95% confidence interval: 1.11–5.32, P = 0.026) in a propensity score-based inverse probability of treatment weighting multivariate Cox proportional hazards analysis.</p> Conclusion <p>Pre-transplant TAC blood concentration fluctuations, particularly a large decrease at 12&#xa0;h from baseline, may be associated with increased BKV infection risk.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Pre-transplant tacrolimus fluctuations predict BK virus infection risk in kidney transplants

  • 期刊论文

  • 发表日期：

    2025年3月17日

查看全文
  • Hisashi Sakurai,
  • Teppei Okamoto,
  • Anna Yonemaya,
  • Fumiya Yonemaya,
  • Tomoko Hamaya,
  • Hirotake Kodama,
  • Naoki Fujita,
  • Hayato Yamamoto,
  • Kazuyuki Mori,
  • Takeshi Fujita,
  • Atushi Imai,
  • Reiichi Murakami,
  • Hirofumi Tomita,
  • Shingo Hatakeyama,
  • Chikara Ohyama

摘要

Background

BK virus (BKV) infection is a significant complication in kidney transplant recipients, potentially leading to graft loss. The relationship between pre-transplant tacrolimus (TAC) pharmacokinetics and BKV infection risk remains unclear. This study aimed to investigate whether pre-transplant TAC blood concentration fluctuations are associated with BKV infection risk.

Methods

We conducted a retrospective study of 135 living donor kidney transplant recipients at Hirosaki University between 2006 and March 2024. Patients were divided into BKV-infected (BKV) and non-infected (non-BKV) groups. TAC blood concentrations were measured at 4 points, including 0 h (2 h before TAC administration), 4, 6, and 12 h on the day before transplantation. Changes in TAC concentration from baseline (0 h) were calculated for each time point. The concentration/dose (C0/D) ratio was used as an indicator of TAC metabolism rate.

Results

During a median follow-up of 54 months, 29 recipients developed BKV infection. The BKV group had significantly older donors and showed a significantly larger decrease in TAC concentration at 12 h compared to the non-BKV group (-1.5 vs. 0 ng/mL, P = 0.008). There was no significant difference in pre-transplant C0/D ratios between the two groups. A decrease of ≥ 1.5 ng/mL at 12 h was identified as a significant risk factor for BKV infection (hazard ratio: 2.44, 95% confidence interval: 1.11–5.32, P = 0.026) in a propensity score-based inverse probability of treatment weighting multivariate Cox proportional hazards analysis.

Conclusion

Pre-transplant TAC blood concentration fluctuations, particularly a large decrease at 12 h from baseline, may be associated with increased BKV infection risk.