title: Impact of Trough Levels of Tacrolimus on Kidney Function and Graft Survival in Short and Longer Periods After Renal Transplantation.
abstract: BACKGROUND
  Optimizing immunosuppressive treatment in the early posttransplant period is important for achieving long-term graft function and survival.
  
  
  METHODS
  There were 205 renal transplant recipients involved in this study. Patients were divided into groups according to the induction therapy (no induction vs basiliximab/daclizumab vs rabbit antithymocyte globulin), maintenance therapy at the time of transplantation (tacrolimus [TAC] vs cyclosporine), the average trough TAC levels in months 4 to 6 after TO and serum creatinine 5 years after renal transplantation.
  
  
  RESULTS
  The incidence of acute rejection was significantly higher in cyclosporine than in TAC group of patients (P = .0364). The average TAC levels on elapsed time after transplantation significantly decreased (P < .0001). Five years after renal transplantation, there were higher TAC levels (5.6 ± 0.7 ng/mL) in the group with "zero" low levels than in the group with "zero" high levels (4.6 ± 1.1 ng/mL), which was statistically significant (P < .0001). We did not find any difference in graft and patient survival in posttransplant years 2 to 5 according to TAC levels or the induction treatment.
  
  
  CONCLUSIONS
  In our study, we have confirmed that better graft function 5 years after transplantation was connected with higher trough tacrolimus levels on elapsed time after renal transplantation.
authors: Department of Urology with Kidney Transplant Center, University Hospital Bratislava, Bratislava, Slovak Republic.
authors: Z
authors: Z
authors: Žilinská
authors: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine, Martin, Slovak Republic. Electronic address: idedinska@yahoo.co.uk.
authors: I
authors: I
authors: Dedinská
authors: Department of Urology with Kidney Transplant Center, University Hospital Bratislava, Bratislava, Slovak Republic.
authors: J
authors: J
authors: Breza
authors: Surgery Clinic and Transplant Center, University Hospital Martin and Jessenius Faculty of Medicine, Martin, Slovak Republic.
authors: L
authors: L
authors: Laca
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000627:therapeutic use*; D015994:Incidence; D016030:Kidney Transplantation; D060046:Maintenance Chemotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000097:blood / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus