ORCID
- Cramp, Matthew: 0000-0002-1152-0568
Abstract
Background Renal dysfunction post liver transplantation (LT) is common. We report our real-world experience of IL2Ra induction with immediate exposure to reduced dose tacrolimus used for patients with chronic kidney disease (CKD) and evolving acute kidney injury (AKI). Method A single-centre retrospective analysis of elective adult LT from 1/1/17 to 31/12/17. The primary outcome measure was increase in CKD stage at month 6 post-LT, and secondary outcome was early biopsy proven acute rejection (BPAR). Results 161 patients were included: 17 planned-IL2Ra for CKD; 38 unplanned-IL2Ra for AKI; and 106 standard immunosuppression. IL2Ra group had lower trough tacrolimus levels till month 3 post-LT. Patients receiving IL2Ra did not have an increased risk of increase in CKD class at month 6 (aOR 0.95, 95% CI 0.34–2.75, P = 0.92), or of early BPAR (aOR 0.53, 95% CI 0.19–1.32, P = 0.19). Conclusion IL2Ra induction with immediate exposure to reduced dose tacrolimus can be given to patients with CKD or early evolving AKI post-LT, with no greater attrition of renal function at 6 months or an increased risk of early BPAR when compared to standard IS. Longer-term outcome data is required, however this regimen can be considered for high risk LT recipients with CKD and AKI.
DOI
10.1016/j.liver.2021.100028
Publication Date
2021-07-01
Publication Title
Journal of Liver Transplantation
Volume
3
Embargo Period
2022-02-26
Organisational Unit
Peninsula Medical School
Recommended Citation
Nayagam, J., Tavabie, O., Norton, B., McMahon, M., Ramos, K., Cadden, I., Cramp, M., Menon, K., Prachalias, A., Agarwal, K., Heneghan, M., Joshi, D., & Aluvihare, V. (2021) 'Interleukin-2 receptor antibody induction with early low dose tacrolimus preserves post-liver transplant renal function in at risk individuals', Journal of Liver Transplantation, 3. Available at: https://doi.org/10.1016/j.liver.2021.100028
