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Living donor liver transplant recipients achieve relatively higher immunosuppressant blood levels than cadaveric recipients.
Liver Transpl 2002; 8(3):212-8LT

Abstract

Two recent brief reports suggest that recipients of living donor liver transplants achieve higher levels of immunosuppressive agents than cadaveric (CAD) liver transplant recipients administered the same dose. These results could have important implications regarding the dosing of immunosuppressives in living donor liver transplant recipients. We report our findings relative to immunosuppressive doses and levels in a cohort of 46 living donor liver transplant recipients. Immunosuppressive blood levels and doses were recorded weeks 1, 2, 3, and 4 and months 2, 3, 4, 5, and 6 for 46 living donor liver transplant recipients and 66 matched CAD liver transplant recipients who underwent transplantation between August 1997 and May 2001. The ratio of level to dose also was recorded at each interval. The mean overall cyclosporine A dose was similar in living donor liver transplant recipients (323 mg/d) compared with CAD recipients (344 mg/d; P = not significant [NS]). The mean overall tacrolimus dose was 15% lower in patients who underwent living donor liver transplantation (LDLT; 5.7 mg/d) than CAD transplantation (6.7 mg/d), although statistical significance was not achieved (P =.08). The mean overall cyclosporine A level was 18% higher in those undergoing LDLT (275 ng/mL) than CAD transplantation (234 ng/mL; P =.015). The mean overall tacrolimus level was the same in living donor liver transplant recipients (10.8 ng/mL) and CAD recipients (10.2 ng/mL; P = NS). The overall cyclosporine A level-dose ratio was 26% higher for those undergoing LDLT (0.83) than CAD transplantation (0.66; P =.01). The overall tacrolimus level-dose ratio was 26% higher for those undergoing LDLT (1.82) than CAD transplantation (1.44; P =.01). In conclusion, (1) living donor liver transplant recipients achieve higher blood levels of tacrolimus and cyclosporine A for a given dose compared with CAD recipients, and (2) this difference is observed up to 6 months after transplantation, when hepatic regeneration is completed.

Authors+Show Affiliations

Division of Gastroenterology/Hepatology, University of Colorado Health Sciences Center, Denver, CO, USA. james.trotter@uchsc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11910565

Citation

Trotter, James F., et al. "Living Donor Liver Transplant Recipients Achieve Relatively Higher Immunosuppressant Blood Levels Than Cadaveric Recipients." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 8, no. 3, 2002, pp. 212-8.
Trotter JF, Stolpman N, Wachs M, et al. Living donor liver transplant recipients achieve relatively higher immunosuppressant blood levels than cadaveric recipients. Liver Transpl. 2002;8(3):212-8.
Trotter, J. F., Stolpman, N., Wachs, M., Bak, T., Kugelmas, M., Kam, I., & Everson, G. T. (2002). Living donor liver transplant recipients achieve relatively higher immunosuppressant blood levels than cadaveric recipients. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 8(3), pp. 212-8.
Trotter JF, et al. Living Donor Liver Transplant Recipients Achieve Relatively Higher Immunosuppressant Blood Levels Than Cadaveric Recipients. Liver Transpl. 2002;8(3):212-8. PubMed PMID: 11910565.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Living donor liver transplant recipients achieve relatively higher immunosuppressant blood levels than cadaveric recipients. AU - Trotter,James F, AU - Stolpman,Nancy, AU - Wachs,Michael, AU - Bak,Thomas, AU - Kugelmas,Marcelo, AU - Kam,Igal, AU - Everson,Gregory T, PY - 2002/3/23/pubmed PY - 2002/6/19/medline PY - 2002/3/23/entrez SP - 212 EP - 8 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl. VL - 8 IS - 3 N2 - Two recent brief reports suggest that recipients of living donor liver transplants achieve higher levels of immunosuppressive agents than cadaveric (CAD) liver transplant recipients administered the same dose. These results could have important implications regarding the dosing of immunosuppressives in living donor liver transplant recipients. We report our findings relative to immunosuppressive doses and levels in a cohort of 46 living donor liver transplant recipients. Immunosuppressive blood levels and doses were recorded weeks 1, 2, 3, and 4 and months 2, 3, 4, 5, and 6 for 46 living donor liver transplant recipients and 66 matched CAD liver transplant recipients who underwent transplantation between August 1997 and May 2001. The ratio of level to dose also was recorded at each interval. The mean overall cyclosporine A dose was similar in living donor liver transplant recipients (323 mg/d) compared with CAD recipients (344 mg/d; P = not significant [NS]). The mean overall tacrolimus dose was 15% lower in patients who underwent living donor liver transplantation (LDLT; 5.7 mg/d) than CAD transplantation (6.7 mg/d), although statistical significance was not achieved (P =.08). The mean overall cyclosporine A level was 18% higher in those undergoing LDLT (275 ng/mL) than CAD transplantation (234 ng/mL; P =.015). The mean overall tacrolimus level was the same in living donor liver transplant recipients (10.8 ng/mL) and CAD recipients (10.2 ng/mL; P = NS). The overall cyclosporine A level-dose ratio was 26% higher for those undergoing LDLT (0.83) than CAD transplantation (0.66; P =.01). The overall tacrolimus level-dose ratio was 26% higher for those undergoing LDLT (1.82) than CAD transplantation (1.44; P =.01). In conclusion, (1) living donor liver transplant recipients achieve higher blood levels of tacrolimus and cyclosporine A for a given dose compared with CAD recipients, and (2) this difference is observed up to 6 months after transplantation, when hepatic regeneration is completed. SN - 1527-6465 UR - https://www.unboundmedicine.com/medline/citation/11910565/Living_donor_liver_transplant_recipients_achieve_relatively_higher_immunosuppressant_blood_levels_than_cadaveric_recipients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1527646502168018 DB - PRIME DP - Unbound Medicine ER -