ArticlePediatric nephrology (Berlin, Germany)2016
Sirolimus and tacrolimus coefficient of variation is associated with rejection, donor-specific antibodies, and nonadherence.
Article in Pediatric nephrology (Berlin, Germany), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05335538 (The Role of TruGraf® to Optimize Outcomes in Pediatric Renal Transplantation), which is not on this map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Role of TruGraf® to Optimize Outcomes in Pediatric Renal Transplantation
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Patient-Reported Outcomes for Pediatric Adherence and Self-Management: A Systematic Review.Journal of pediatric psychology · 2020Pooled it
- Video Education and Behavior Contract to Improve Outcomes After Renal Transplantation (VECTOR): A Randomized Controlled Trial.Patient preference and adherence · 2024Trial
- Substance Use Patterns in Pediatric Solid Organ Transplant Candidates: Impact After Transplant.Pediatric transplantation · 2026Article
- Integrating Tissue Gene Expression Profiling With Histopathology in Pediatric Kidney Recipients.Pediatric transplantation · 2026Article
- Influence of intrapatient variability in tacrolimus trough levels on acute rejection in pediatric kidney transplant recipients.Pediatric nephrology (Berlin, Germany) · 2026Article
- Early major adverse kidney events after lung transplantation: risk of chronic kidney disease and prognostic impact.General thoracic and cardiovascular surgery · 2026Article
- Association of intrapatient tacrolimus variability and concentration-to-dose ratio with outcomes in pediatric kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2025Article
- When would I be surprised? Variability in predicted probability of survival for being "surprised" and "not surprised" to the surprise question.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Histone acetylation facilitates multidirectional pulp repair through Neuregulin-1 mobilization.Stem cells translational medicine · 2025Article
- Tacrolimus IPV Group Membership Does Not Consistently Track With Electronically Monitored or Self-reported Adherence in Adolescent and Young Adult Kidney Transplant Recipients.Transplantation direct · 2025Article
- Inter-Dose Variability of Immunosuppressant Medication Among Adolescent Heart Transplants During Video Directly Observed Therapy.Pediatric transplantation · 2025Article
- A pharmacist-led intervention to improve kidney transplant recipient outcomes and identify patients at risk of highly variable trough tacrolimus levels: a cohort study.European journal of hospital pharmacy : science and practice · 2024Article
- Patient Engagement and Medication Consistency with Adolescent Heart Transplant Recipients.Proceedings. IEEE International Conference on Healthcare Informatics · 2024Article
- Impact of tacrolimus intra-patient variability in adverse outcomes after organ transplantation.World journal of transplantation · 2023Review
- Association of intraindividual tacrolimus variability with de novo donor-specific HLA antibody development and allograft rejection in pediatric kidney transplant recipients with low immunological risk.Pediatric nephrology (Berlin, Germany) · 2022Article
- Review and Evaluation of mHealth Apps in Solid Organ Transplantation: Past, Present, and Future.Transplantation direct · 2022Review
- Process Optimization for Acid Hydrolysis and Characterization of Bioethanol from Leftover Injera Waste by Using Response Surface Methodology: Central Composite Design.International journal of analytical chemistry · 2022Article
- Evaluation of Cumulative Effect of Standard Triple Immunosuppression on Prevention of De Novo Donor Specific Antibodies (dnDSA) Production in Children after Kidney Transplantation-A Retrospective and Prospective Study.Children (Basel, Switzerland) · 2021Article
- Retrospective Analysis of Tacrolimus Intrapatient Variability as a Measure of Medication Adherence.Canadian journal of kidney health and disease · 2021Article
- Impacts of High Intra- and Inter-Individual Variability in Tacrolimus Pharmacokinetics and Fast Tacrolimus Metabolism on Outcomes of Solid Organ Transplant Recipients.Journal of clinical medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundImmunosuppression medication nonadherence has been associated with donor-specific antibodies and treatment-refractory rejection. Drug-level monitoring is a practical direct marker for nonadherence, as variations indicate erratic ingestion of medication. We previously reported that high variability in tacrolimus trough levels determined by the percent coefficient of variation (CV %) and standard deviation (SD) were associated with biopsy-proven rejection. We hypothesized that the CV % and SD in patients on a sirolimus/low-dose tacrolimus regimen may associate with self-reported medication nonadherence, rejection and donor-specific antibodies.
methodsIn this pilot feasibility study, we studied 37 biopsies in 23 pediatric renal transplant patients on both sirolimus and tacrolimus immunosuppression; CV %, SD, de novo donor-specific antibodies, rejection, and self-reported adherence were examined.
resultsA cut-off sirolimus CV % of 25 maximized the percentage of biopsies correctly classified as rejection (32 of 37, or 86 %, p = 0.001). A cut-off tacrolimus CV % of 31 maximized the percentage of correctly classified biopsies (25 of 37, or 68 %, p = 0.09). Among patients with both high sirolimus and tacrolimus CV %, 67 % developed de novo donor-specific antibodies (p = 0.002) with a DQ predominance and 71 % reported nonadherence (p = 0.05).
conclusionsIn pediatric renal transplantation, sirolimus and tacrolimus CV % is a potential tool for monitoring patients at risk for allograft rejection and donor-specific antibodies secondary to medication nonadherence.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.