High Tacrolimus Intra‐Patient Variability and Adverse Outcomes in Cardiac Transplant Recipients: A Single‐Center Study in China
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Wiley
2025
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| _version_ | 1867019503184904193 |
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| author | Zhenzhen Wang Hua Zheng Mian Zhang Yibo Wang Yunfei Liu Dong Zeng Hongxiang Zheng Bin Yang Lin Guo |
| author_facet | Zhenzhen Wang Hua Zheng Mian Zhang Yibo Wang Yunfei Liu Dong Zeng Hongxiang Zheng Bin Yang Lin Guo Zhenzhen Wang Hua Zheng Mian Zhang Yibo Wang Yunfei Liu Dong Zeng Hongxiang Zheng Bin Yang Lin Guo |
| collection | Wiley Open Access |
| contents | High Tacrolimus Intra‐Patient Variability and Adverse Outcomes in Cardiac Transplant Recipients: A Single‐Center Study in China Zhenzhen Wang Hua Zheng Mian Zhang Yibo Wang Yunfei Liu Dong Zeng Hongxiang Zheng Bin Yang Lin Guo Clinical Transplantation ABSTRACT Purpose To evaluate the association between tacrolimus intra‐patient variability (IPV) and the prognosis of cardiac transplant recipients. Methods Tacrolimus trough concentrations (C 0 ) from cardiac transplant recipients were collected during the postoperative months 3–6. Dose‐adjusted IPV values were calculated, and recipients were divided into high‐IPV and low‐IPV groups. The composite endpoint was defined as the occurrence of any one of the following: infection, rejection, or mortality. Results A total of 202 recipients were included. The incidence of infections was significantly higher in the high‐IPV group (34.8% vs. 21.1%, χ 2 = 4.480, p = 0.034). The risk of infection and composite endpoint occurrence was approximately 2.2 and 2.1 times higher, respectively, in the high‐IPV group than in the low‐IPV group, with hazard ratios (HR) and 95% CIs of 2.215 (1.175–3.842) and 2.061 (1.258–3.378). No significant differences were observed between the two groups in terms of rejection or mortality ( p > 0.05). Cox regression analysis revealed that the relative risk of composite endpoint occurrence in the high‐IPV group was 2.024 times higher than in the low‐IPV group. The cumulative event‐free survival rates for the composite endpoint differed significantly between the two groups. Log‐rank testing of the survival curves yielded p = 0.004 and HR = 2.061 (95% CI: 1.258–3.378). Conclusion Cardiac transplant recipients with high tacrolimus IPV may be at increased risk of adverse events such as infections. Tacrolimus IPV, which is simple to calculate, can serve as a useful follow‐up tool for predicting postoperative adverse outcomes. 10.1111/ctr.70427 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/ctr.70427 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_ctr_70427 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | High Tacrolimus Intra‐Patient Variability and Adverse Outcomes in Cardiac Transplant Recipients: A Single‐Center Study in China Zhenzhen Wang Hua Zheng Mian Zhang Yibo Wang Yunfei Liu Dong Zeng Hongxiang Zheng Bin Yang Lin Guo Clinical Transplantation High Tacrolimus Intra‐Patient Variability and Adverse Outcomes in Cardiac Transplant Recipients: A Single‐Center Study in China Zhenzhen Wang Hua Zheng Mian Zhang Yibo Wang Yunfei Liu Dong Zeng Hongxiang Zheng Bin Yang Lin Guo Clinical Transplantation ABSTRACT Purpose To evaluate the association between tacrolimus intra‐patient variability (IPV) and the prognosis of cardiac transplant recipients. Methods Tacrolimus trough concentrations (C 0 ) from cardiac transplant recipients were collected during the postoperative months 3–6. Dose‐adjusted IPV values were calculated, and recipients were divided into high‐IPV and low‐IPV groups. The composite endpoint was defined as the occurrence of any one of the following: infection, rejection, or mortality. Results A total of 202 recipients were included. The incidence of infections was significantly higher in the high‐IPV group (34.8% vs. 21.1%, χ 2 = 4.480, p = 0.034). The risk of infection and composite endpoint occurrence was approximately 2.2 and 2.1 times higher, respectively, in the high‐IPV group than in the low‐IPV group, with hazard ratios (HR) and 95% CIs of 2.215 (1.175–3.842) and 2.061 (1.258–3.378). No significant differences were observed between the two groups in terms of rejection or mortality ( p > 0.05). Cox regression analysis revealed that the relative risk of composite endpoint occurrence in the high‐IPV group was 2.024 times higher than in the low‐IPV group. The cumulative event‐free survival rates for the composite endpoint differed significantly between the two groups. Log‐rank testing of the survival curves yielded p = 0.004 and HR = 2.061 (95% CI: 1.258–3.378). Conclusion Cardiac transplant recipients with high tacrolimus IPV may be at increased risk of adverse events such as infections. Tacrolimus IPV, which is simple to calculate, can serve as a useful follow‐up tool for predicting postoperative adverse outcomes. 10.1111/ctr.70427 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | High Tacrolimus Intra‐Patient Variability and Adverse Outcomes in Cardiac Transplant Recipients: A Single‐Center Study in China |
| topic | Clinical Transplantation |
| url | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70427 |