Effect of early blood concentrations of tacrolimus on the survival of patients after liver transplantation
10.3760/cma.j.cn113884-20250218-00051
- VernacularTitle:早期他克莫司浓度对肝移植受者术后生存的影响
- Author:
Junyang XIAO
1
;
Jianyong LIU
1
;
Jiajia SHEN
1
;
Yi JIANG
1
;
Fang YANG
1
;
Lizhi LYU
1
;
Qiucheng CAI
1
Author Information
1. 福建医科大学福总临床医学院（中国人民解放军联勤保障部队第九〇〇医院）肝胆外科，福州 350025
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Immunosuppressant;
Tacrolimus;
Complications;
Survival
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(10):744-749
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the impact of early blood concentrations of tacrolimus on the survival of patients after liver transplantation.Methods:Clinical data of 159 patients with liver diseases undergoing classic orthotopic liver transplantation at the Department of Hepatobiliary Surgery, the 900th Hospital of the Joint Logistics Support Force between January 2010 and December 2019 were retrospectively analyzed, including 123 males and 36 females, aged (48.0±12.2) years. According to survival status, patients were divided into the surviving group ( n=108) and death group ( n=51). Inverse probability of treatment weighting (IPTW) was applied to adjust for confounding factors by weighting covariates between the two groups. Univariate and multivariate Cox regression analysis were used to examine the relationship between early tacrolimus concentrations and mortality, and restrict cubic spline (RCS) curves were employed to assess the nonlinear relationship further. Results:After IPTW weighting, multivariate Cox regression analysis indicated that early tacrolimus concentration ( HR=2.479, 95% CI: 1.354-4.537, P<0.001) and preoperative international normalized ratio ( HR=0.358, 95% CI: 0.162-0.792, P=0.011) levels were risk factors for post-transplant survival. The RCS curve revealed that the optimal thresholds for early tacrolimus concentration were 6.30 ng/ml and 8.28 ng/ml ( P<0.001). Patients were therefore divided into the optimal concentration group ( n=60) and the non-optimal concentration group ( n=99). After IPTW weighting, the optimal concentration group comprised 102 cases, and the non-optimal concentration group included 212 cases. The 1-year, 3-year and 5-year survival rates in the optimal concentration group and the non-optimal concentration group were 97.06%, 81.37% and 75.49%, and 86.32%, 64.62% and 50.94%, respecitvely ( χ2=8.37, P<0.001). Conclusion:Early tacrolimus concentration is an independent risk factor for post-transplant survival. A tacrolimus concentration >8.28 ng/ml or <6.30 ng/ml is associated with a relatively higher mortality rate.
