Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection

Abstract BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN pa...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Chia-Lin Shen, An-Hang Yang, Tse-Jen Lien, Der-Cherng Tarng, Chih-Yu Yang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/552d23547ab74e24ba2c72daa7d7536e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:552d23547ab74e24ba2c72daa7d7536e
record_format	dspace
spelling	oai:doaj.org-article:552d23547ab74e24ba2c72daa7d7536e2021-12-02T16:06:24ZTacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection10.1038/s41598-017-02140-12045-2322https://doaj.org/article/552d23547ab74e24ba2c72daa7d7536e2017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-02140-1https://doaj.org/toc/2045-2322Abstract BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN patients with coexisting acute rejection, and 21 patients with BKVN alone. We retrospectively analyzed the dosage and blood concentrations of immunosuppressants during the 3-month period prior to the renal biopsy between the two patient groups. Compared to the BKVN alone group, renal function was noticeably worse in the coexistence group (p = 0.030). Regarding the dose and average drug level of immunosuppressants, there was no difference between the two groups. Interestingly, the coefficient of variance of tacrolimus trough blood level was noticeably higher during the 3-month period prior to the renal biopsy in the coexistence group (p = 0.010). Our novel findings suggest that a higher variability of tacrolimus trough level may be associated with the coexistence of BKVN and acute rejection. Since the prognosis is poor and the treatment is challenging in patients with coexisting BKVN and acute rejection, transplant clinicians should strive to avoid fluctuations in immunosuppressant drug levels in patients with either one of these two disease entities.Chia-Lin ShenAn-Hang YangTse-Jen LienDer-Cherng TarngChih-Yu YangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chia-Lin Shen An-Hang Yang Tse-Jen Lien Der-Cherng Tarng Chih-Yu Yang Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection
description	Abstract BK virus nephropathy (BKVN) and allograft rejection are two distinct disease entities which occur at opposite ends of the immune spectrum. However, they coexist in renal transplant recipients. Predisposing factors for this coexistence remain elusive. We identified nine biopsy-proven BKVN patients with coexisting acute rejection, and 21 patients with BKVN alone. We retrospectively analyzed the dosage and blood concentrations of immunosuppressants during the 3-month period prior to the renal biopsy between the two patient groups. Compared to the BKVN alone group, renal function was noticeably worse in the coexistence group (p = 0.030). Regarding the dose and average drug level of immunosuppressants, there was no difference between the two groups. Interestingly, the coefficient of variance of tacrolimus trough blood level was noticeably higher during the 3-month period prior to the renal biopsy in the coexistence group (p = 0.010). Our novel findings suggest that a higher variability of tacrolimus trough level may be associated with the coexistence of BKVN and acute rejection. Since the prognosis is poor and the treatment is challenging in patients with coexisting BKVN and acute rejection, transplant clinicians should strive to avoid fluctuations in immunosuppressant drug levels in patients with either one of these two disease entities.
format	article
author	Chia-Lin Shen An-Hang Yang Tse-Jen Lien Der-Cherng Tarng Chih-Yu Yang
author_facet	Chia-Lin Shen An-Hang Yang Tse-Jen Lien Der-Cherng Tarng Chih-Yu Yang
author_sort	Chia-Lin Shen
title	Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection
title_short	Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection
title_full	Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection
title_fullStr	Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection
title_full_unstemmed	Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection
title_sort	tacrolimus blood level fluctuation predisposes to coexisting bk virus nephropathy and acute allograft rejection
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/552d23547ab74e24ba2c72daa7d7536e
work_keys_str_mv	AT chialinshen tacrolimusbloodlevelfluctuationpredisposestocoexistingbkvirusnephropathyandacuteallograftrejection AT anhangyang tacrolimusbloodlevelfluctuationpredisposestocoexistingbkvirusnephropathyandacuteallograftrejection AT tsejenlien tacrolimusbloodlevelfluctuationpredisposestocoexistingbkvirusnephropathyandacuteallograftrejection AT dercherngtarng tacrolimusbloodlevelfluctuationpredisposestocoexistingbkvirusnephropathyandacuteallograftrejection AT chihyuyang tacrolimusbloodlevelfluctuationpredisposestocoexistingbkvirusnephropathyandacuteallograftrejection
_version_	1718385022038179840

Tacrolimus Blood Level Fluctuation Predisposes to Coexisting BK Virus Nephropathy and Acute Allograft Rejection

Ejemplares similares