title: Higher tacrolimus blood concentration is related to hyperlipidemia in living donor liver transplantation recipients.
abstract: BACKGROUND
  The arrival of tacrolimus has drastically improved AALDLT recipients' survival. However, little data of tacrolimus have been reported concerning its effects on lipid metabolism for AALDLT recipients.
  
  
  OBJECTIVE
  Out aim was to investigate the relationship between tacrolimus blood concentration and lipid metabolism in AALDLT recipients.
  
  
  METHODS
  The pre and postoperative data of 77 adult patients receiving AALDLT between 2002 and December 2007 were retrospectively reviewed. The postoperative immune suppressive regimen was prednisone with tacrolimus ± mycophenolate mofetil. Prednisone was withdrawn within the first postoperative month. Blood lipids and tacrolimus concentration were detected at the first, third, and sixth month during follow-up. Episodes of acute rejection were diagnosed based on biopsy.
  
  
  RESULTS
  Overall prevalence of post-transplantation hyperlipidemia was 29.9% (23/77) at the sixth postoperative month. The patients were divided into two groups, the hyperlipidemia group and the ortholipidemia group. In the 23 patients with hyperlipidemia, 15 (65%) were hypercholesterolemia, five (22%) were hypertriglyceridemia, and three (13%) patients had both hypercholesterolemia and hypertriglyceridemia. In univariate analysis, only tacrolimus blood concentration at the third and sixth post-transplantation months showed significant difference (8.7 ± 2.1 vs. 6.9 ± 3.2, p = 0.013; 9.2 ± 2.7 vs. 7.3 ± 3.8, p = 0.038, respectively). In multivariate logistic analysis, only two factors appear to be risk factors, namely, tacrolimus blood concentration at the third and sixth post-transplantation months (8.7 ± 2.1 vs. 6.9 ± 3.2, p = 0.043; 9.2 ± 2.7 vs. 7.3 ± 3.8 p = 0.035, respectively).
  
  
  CONCLUSIONS
  Higher tacrolimus blood concentration was related to hyperlipidemia at an early postoperative period. This indicates that tacrolimus blood concentration should be controlled as low as possible in the premise that there is no risk of rejection to minimize post-transplant hyperlipidemia after AALDLT.
authors: Department of Liver and Vascular Surgery, Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan, China.
authors: Hong-Yu
authors: HY
authors: Li
authors: Bo
authors: B
authors: Li
authors: Yong-Gang
authors: YG
authors: Wei
authors: Lv-Nan
authors: LN
authors: Yan
authors: Tian-Fu
authors: TF
authors: Wen
authors: Ji-Chun
authors: JC
authors: Zhao
authors: Ming-Qing
authors: MQ
authors: Xu
authors: Wen-Tao
authors: WT
authors: Wang
authors: Yu-Kui
authors: YK
authors: Ma
authors: Jia-Yin
authors: JY
authors: Yang
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000453:epidemiology*; D007166:Immunosuppressive Agents / Q000097:blood; D050356:Lipid Metabolism / Q000502:physiology; D016031:Liver Transplantation / Q000276:immunology / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000097:blood*; D014180:Transplantation
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus