Evidence map›Paper›PMID 32614859›Full record

Observational studyPloS one2020

Tacrolimus trough levels higher than 6 ng/mL might not be required after a year in stable kidney transplant recipients.

Hee-Yeon Jung, Min Young Seo, Yena Jeon, Kyu Ha Huh, Jae Berm Park, Cheol Woong Jung, Sik Lee, Seung-Yeup Han, Han Ro, Jaeseok Yang and 6 more

Open access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 10 institutions in 1 country.

Hee-Yeon JungDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Min Young SeoDepartment of Internal Medicine, Pohang St. Mary's Hospital, Pohang, South Korea.
Yena JeonDepartment of Statistics, Kyungpook National University, Daegu, South Korea.
Kyu Ha HuhDepartment of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Jae Berm ParkDepartment of Surgery, Sungkyunkwan University, Seoul Samsung Medical Center, Seoul, South Korea.ORCID 0000-0001-9117-2278
Cheol Woong JungDepartment of Surgery, Korea University College of Medicine, Seoul, South Korea.
Sik LeeDepartment of Internal Medicine, Chonbuk National University Hospital, Jeonju, South Korea.
Seung-Yeup HanDepartment of Internal Medicine, Keimyung University, Dongsan Medical Center, Daegu, South Korea.
Han RoDepartment of Internal Medicine, Gachon University, Gil Hospital, Incheon, South Korea.
Jaeseok YangDepartment of Surgery, Seoul National University College of Medicine, Seoul, South Korea.
Curie AhnDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Ji-Young ChoiDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Jang-Hee ChoDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Sun-Hee ParkDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Yong-Lim KimDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Chan-Duck KimDepartment of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.ORCID 0000-0002-4648-0324
Kyungpook National University Hospital · KRSeoul National University · KRDeleted InstitutionJeonbuk National University Hospital · KRKeimyung University Dongsan Medical Center · KRKorea University · KRKyungpook National University · KRPohang TechnoPark (South Korea) · KRSamsung Medical Center · KRYonsei University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLittle is known regarding optimal tacrolimus (TAC) trough levels after 1 year post-transplant in stable kidney transplant recipients (KTRs) who have not experienced renal or cardiovascular outcomes. This study aimed to investigate the effect of 1-year post-transplant TAC trough levels on long-term renal and cardiovascular outcomes and opportunistic infections in stable KTRs.

methodsKTRs receiving TAC with mycophenolate-based immunosuppression who did not experience renal or cardiovascular outcomes within 1 year post-transplant were enrolled from a multicenter observational cohort study. Renal outcome was defined as a composite of biopsy-proven acute rejection, interstitial fibrosis and tubular atrophy, and death-censored graft loss. Cardiovascular outcome was defined as a composite of de novo cardiomegaly, left ventricular hypertrophy, and cardiovascular events. Opportunistic infections were defined as the occurrence of BK virus or cytomegalovirus infections.

resultsA total of 603 eligible KTRs were divided into the low-level TAC (LL-TAC) and high-level TAC (HL-TAC) groups based on a median TAC level of 5.9 ng/mL (range 1.3-14.3) at 1 year post-transplant. The HL-TAC group had significantly higher TAC trough levels at 2, 3, 4, and 5 years compared with the levels of the LL-TAC group. During the mean follow-up of 63.7 ± 13.0 months, there were 121 renal outcomes and 224 cardiovascular outcomes. In multivariate Cox regression analysis, LL-TAC and HL-TAC were not independent risk factors for renal and cardiovascular outcomes, respectively. No significant differences in the development of opportunistic infections and de novo donor-specific anti-human leukocyte antigen antibodies and renal allograft function were observed between the two groups.

conclusionsTAC trough levels after 1 year post-transplant remained at a similar level until the fifth year after kidney transplantation and were not directly associated with long-term outcomes in stable Korean KTRs who did not experience renal or cardiovascular outcomes. Therefore, in Asian KTRs with a stable clinical course, TAC trough levels higher than approximately 6 ng/mL might not be required after a year of kidney transplantation.

Indexed as

Immunosuppressive AgentsTacrolimusAdultCardiovascular DiseasesCohort StudiesCytomegalovirus InfectionsFemaleGraft RejectionHumansImmunosuppression TherapyKidney TransplantationMaleMiddle AgedOpportunistic InfectionsPolyomavirus InfectionsRenal InsufficiencyImmunosuppressive AgentsTacrolimus

Identifiers

PMID32614859
PMCPMC7332007
OpenAlexW3039578012

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.