Kidney Week

Abstract: SA-PO513

Is There a Relationship Between HLA Mismatch and Intra-Patient Tacrolimus Variability in Kidney Transplant Patients? A Comparative Multi-Centre Retrospective Study

Session Information

• Immunosuppression, Disease Recurrence, and Malignancy
  November 04, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Transplantation

• 1702 Transplantation: Clinical and Translational

Authors

• Papachristos, Stavros, Central Manchester Foundation Trust, Manchester, United Kingdom

Stavros Papachristos,

• Forgacs, Bence, Manchester Royal Infirmasry, Manchester, United Kingdom

Bence Forgacs,

• John velvet, Anju john, Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom

Anju john John velvet,

• Okidi, Okechukwu Onuma, Central Manchester NHS Foundation Trust UK, Manchester, United Kingdom

Okechukwu Onuma Okidi,

Group or Team Name

• UK Tacrolimus Audit Collaborative

Background

Tacrolimus (Tac) is a critical component of immunosuppressive therapy after kidney transplantation (tx). It has been previously reported that high Tac Intrapatient Variability (IPV) (patient’s trough level variability over time) is associated with higher rejection episodes and poor long term outcome after kidney tx. The relationship between HLA mismatch (MM) and Tac IPV has not been previously evaluated.

Methods

1068 kidney transplant recipients in 5 UK centres between 2009-2014 and who were taking standard release Tac preparations were included in the study. IPV data was retrospectively collected from 2 time points – 6-12months post-transplant (T1) and the last 12 months of follow up (T2). Patients were divided into a high immunological risk HLA MM (HLA MM 4-6) and a low risk HLA MM group (HLA MM 0-3). Association between HLA MM and IPV was evaluated for each centre.

Results

Table 1 demonstrates the results of 1068 patients included from 5 UK centres. When comparing IPV≤20% and IPV>20%, there was no significant correlation with the high risk HLA MM group or the low risk HLA MM group (p>0.1 for all comparisons). The relation between HLA mismatch and Tacrolimus IPV did not reach significance in T1 and T2 periods in all centres.

Conclusion

This study represents the first and largest population based evaluation of relation between HLA mismatch and IPV. Our results demonstrate a clear evidence that HLA mismatch does not affect Tac IPV in either early or late post operative periods. This finding is consistent between 5 UK tx centres. Therefore, HLA mismatch should not be considered as a factor that affects Tac IPV for kidney transplant patients.

Funding

• Commercial Support – Astellas Pharma LTD