Annals of Thoracic Medicine Official publication of the Saudi Thoracic Society, affiliated to King Saud University
Search Ahead of print Current Issue Archives Instructions Subscribe e-Alerts Login 
Home Email this article link Print this article Bookmark this page Decrease font size Default font size Increase font size
Year : 2019  |  Volume : 14  |  Issue : 3  |  Page : 186-191

Low early posttransplant serum tacrolimus levels are associated with poor patient survival in lung transplant patients

1 Transplant Center, Seoul National University Hospital, Seoul, Republic of Korea
2 Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
3 Department of Thoracic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
4 Transplant Center; Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea

Correspondence Address:
Dr. Jaeseok Yang
Transplantation Center, Department of Surgery, Seoul National University Hospital, Transplantation Research Institute, Seoul National University College of Medicine, 101, Daehak-ro, Chongno-gu, Seoul
Republic of Korea
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/atm.ATM_160_18

Rights and Permissions

BACKGROUND: Low-dose tacrolimus-based immunosuppression is a standard therapy in kidney and liver transplantation; however, the optimal therapeutic level of tacrolimus has not been established in lung transplantation. We aimed to identify the tacrolimus level associated with better outcomes in lung transplant patients. METHODS: This retrospective study included patients who underwent lung transplantation at Seoul National University Hospital between 2006 and 2016. Kaplan–Meier survival analysis and Cox regression were performed according to tacrolimus levels at several time-points within 1-year posttransplantation. RESULTS: A total of 43 patients received bilateral lung transplantation. The median age was 53 years and the median follow-up was 20.5 months. Overall and 1-year patient survival rates were 55.8% and 74.4%, respectively. Infection was the most common cause of death (78.9%). Chronic lung allograft dysfunction was observed in 16.3%. A tacrolimus level <9 ng/ml at 1 month was associated with lower rejection-free survival (P = 0.009). A time-averaged tacrolimus level <10 ng/ml within 1 month posttransplantation was an independent risk factor for poor patient survival (hazard ratio: 4.904; 95% confidence interval: 1.930–12.459; P= 0.001). Furthermore, higher tacrolimus levels did not increase infectious complications. CONCLUSIONS: These finding suggest that tacrolimus levels ≥10 ng/ml within 1 month after lung transplantation appear to be associated with better patient survival.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded331    
    Comments [Add]    
    Cited by others 5    

Recommend this journal