Jia JJ, Lin BY, He JJ, Geng L, Kadel D, Wang L, Yu DD, Shen T, Yang Z, Ye YF, Zhou L, Zheng SS. ''Minimizing tacrolimus'' strategy and long-term survival after liver transplantation. World J Gastroenterol 2014; 20(32): 11363-11369 [PMID: 25170223 DOI: 10.3748/wjg.v20.i32.11363]
Corresponding Author of This Article
Shu-Sen Zheng, MD, PhD, FACS, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou 310003, Zhejiang Province, China. shusenzheng@zju.edu.cn
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 28, 2014; 20(32): 11363-11369 Published online Aug 28, 2014. doi: 10.3748/wjg.v20.i32.11363
Table 1 Clinical characteristics of 235 consecutive liver transplant patients
Variables
Value
Age (yr)
47.11 ± 11.32
MELD score
16 (range 6-50)
Child score
9 (range 5-15)
Gender
Male
203 (86.4)
Female
32 (13.6)
Etiology
HBV-related
140 (59.6)
Hepatocarcinoma
55 (23.4)
Others
40 (17)
Blood tests
Bilirubin (μmol/L) (NR < 17.1)
162.73 ± 205.39
AST (IU/L) (NR < 50)
240.46 ± 556.16
ALT (IU/L) (NR < 40)
183.2 ± 325.93
Albumin (g/L) (NR 35-50)
34.96 ± 5.47
WBC (× 109/L) (NR 3.5-11)
5.96 ± 4.58
Urea (mmol/L) (NR 3-7.1)
6.70 ± 5.29
Creatinine (μmol/L) (NR 60-97)
94.37 ± 68.98
TC
7.91 ± 2.28
ABO
A-A
85 (36.2)
B-B
51 (21.7)
O-O
87 (37)
AB-AB
12 (5.1)
Table 2 Clinical Fk506-related side effects and cause of death
All events (n)
First events only (n)
Rejection
38
20
Infection
55
26
Renal insufficiency
7
2
Tumor recurrence
36
18
Metabolic disorder
34
21
Cause of death
MODS
11
Tumor recurrence
22
Graft loss
3
Others
11
Table 3 Classification of groups according to mean tacrolimus concentration, death rate and related side effects in respective categories
Group
1
2
3
4
TC interval (ng/mL)
0-5
5-7
7-10
10-15
Total number
21
57
119
38
Number of death
8
9
23
7
Cause of death
MODS
4
4
2
1
Tumor recurrence
2
4
13
3
Graft loss
1
1
0
1
Others
1
0
8
2
Rejection
2
14
16
6
Infection
6
14
24
11
Renal insufficiency
2
2
2
1
Tumor recurrence
5
7
19
5
Metabolic disorder
6
8
15
5
Table 4 Classification of groups according to standard deviation of Tacrolimus concentration, death rate and related side effects in respective categories
Group
1
2
3
SD interval
0-2
2-4
> 4
Total number
21
118
96
Number of death
7
18
22
Cause of death
MODS
4
4
3
Tumor recurrence
2
7
13
Graft loss
0
2
1
Others
1
5
5
Rejection
1
21
16
Infection
5
25
25
Renal insufficiency
0
6
1
Tumor recurrence
3
14
19
Metabolic disorder
2
20
12
Table 5 Variables in multivariate Cox regression equation of long-term survival
B
SE
Wald
df
Sig.
Exp(B)
Lower
Upper
Gender
-0.809
0.352
5.284
1
0.022
0.445
0.224
0.888
Age
0.252
0.612
0.170
1
0.680
1.287
0.388
4.273
Plug score
0.640
0.364
3.093
1
0.079
1.897
0.929
3.870
Meld score
-0.281
0.266
1.113
1
0.291
0.755
0.448
1.272
Diagnosis
-0.351
0.162
4.691
1
0.030
0.704
0.512
0.967
SD of TC
0.345
0.153
5.063
1
0.024
1.412
1.045
1.907
Mean TC
-0.960
0.397
5.830
1
0.016
0.383
0.176
0.835
Citation: Jia JJ, Lin BY, He JJ, Geng L, Kadel D, Wang L, Yu DD, Shen T, Yang Z, Ye YF, Zhou L, Zheng SS. ''Minimizing tacrolimus'' strategy and long-term survival after liver transplantation. World J Gastroenterol 2014; 20(32): 11363-11369