Evidence map›Paper›PMID 41574224›Full record

ArticleFrontiers in transplantation2025

The critical relationship between tacrolimus levels, acute kidney injury, and early chronic lung allograft dysfunction.

Roman Hauber, Luca Kohlhepp, Ignaz Briegel, Tobias Veit, Jürgen Barton, Bruno Meiser, Christian Schneider, Teresa Kauke, Rudolf Hatz, Dominik J Hoechter and 2 more

Abstract read
In one paragraph

Article in Frontiers in transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Review
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

12 authors.

Roman Hauber *Department of Internal Medicine II, Neuwittelsbach Academic Hospital of the University Hospital LMU Munich, Munich, Germany.
Luca Kohlhepp *Center for Artificial Intelligence and Data Science, JMU University of Würzburg, Würzburg, Germany.
Ignaz Briegel *Department of Medicine V, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), University Hospital LMU Munich, Munich, Germany.
Tobias VeitDepartment of Medicine V, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), University Hospital LMU Munich, Munich, Germany.
Jürgen BartonDepartment of Medicine V, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), University Hospital LMU Munich, Munich, Germany.
Bruno MeiserTransplant Center, University Hospital LMU Munich, Munich, Germany.
Christian SchneiderDivision of Thoracic Surgery, University Hospital LMU Munich, Munich, Germany.
Teresa KaukeDivision of Thoracic Surgery, University Hospital LMU Munich, Munich, Germany.
Rudolf HatzDivision of Thoracic Surgery, University Hospital LMU Munich, Munich, Germany.
Dominik J HoechterDepartment of Anaesthesiology, University Hospital LMU Munich, Munich, Germany.
Nikolaus KneidingerDivision of Pulmonology, Department of Internal Medicine, Lung Research Cluster, Medical University of Graz, Graz, Austria.
Jürgen BehrDepartment of Medicine V, Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), University Hospital LMU Munich, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Based on clinical observations, we hypothesized that tacrolimus (TAC) exposure and acute kidney injury (AKI) are associated with the development of chronic lung allograft dysfunction (CLAD) after lung transplantation (LTx). Methods: Of 827 lung transplant recipients treated between 2000 and 2018, 509 with complete data sets from the University Hospital of Munich (LMU) were included in this study. In the context of a 10% reduction in FEV Results: Of 509 LTx patients, 67 (13%) died within the first 2 years after LTx. Among these 67 patients, 38 (57%) developed CLAD10 within 2 years of LTx. In these patients, we observed a temporal pattern characterized by a peak in TAC levels, followed by AKI, and subsequently subtherapeutic TAC concentrations, which occurred a few weeks before the onset of CLAD10. The confounder analysis demonstrated a significant influence of renal failure and tacrolimus fluctuations on the hazards ratio for developing CLAD10. Conclusion: Our data suggest that a transient decline in TAC serum concentrations, often caused by a TAC-induced AKI, may trigger the onset of CLAD10 and subsequently elevate the risk of premature death.

Indexed as

chronic lung allograft dysfunctioncladkidney injurylung transplantationtacrolimus

Identifiers

PMID41574224
PMCPMC12819767

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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.