Article Text

Download PDFPDF

4CPS-096 Tacrolimus variability and comorbidities in lung transplantation
  1. A Sangrador,
  2. R Añez,
  3. J Fernandez-Cabero,
  4. D Gomez,
  5. M Ramis,
  6. M Rioja,
  7. M Valero
  1. Hospital Valdecilla, Pharmacy, Santander, Spain


Background and importance In solid organ transplant patients, intrapatient variability in tacrolimus levels >30% is related to the appearance of specific de novo donor antibodies (dn-DSA) and rejection.

Aim and objectives We wanted to determine if in a cohort of 71 lung transplant patients in 2018 and 2019 this variability is also related to the appearance of post-transplant complications: diabetes, osteoporosis, renal failure, dyslipidaemia and if the sex of the patients and their pre-transplant diagnosis has an influence.

Material and methods Through the hospital’s own lung transplant patient management programme and the hospital’s assisted electronic prescription, the following data were retrospectively analysed: tacrolimus levels from the second post-transplant month and its percentage coefficient of variation (% CV) until December 2020 (% CV: (standard deviation/mean)*100); tacrolimus, prednisone and mycophenolate mofetil dose; onset of diabetes and the drug being treated; glomerular filtration rate (GFR) <60 mL/min/1.73 m2; onset of osteoporosis; appearance of dyslipidaemia; sex; age; and pre-transplant diagnosis. For the statistical analysis, SPSS v.22 was used.

Results Of the 71 lung transplant patients in 2018, 8 died, 21 (30%) were women, 38 (54%) had a% CV of tacrolimus >30%, 32 (45%) had GFR <60 mL/min/1.73 m2, 28 (39%) had osteoporosis, 47 (66%) ha dyslipidaemia and 21 (29%) had diabetes.

The drugs used in the treatment of osteoporosis were: zoledronic acid, denosumab and teriparatide; dyslipidaemia: atorvastatin; and diabetes: metformin and insulin.

After the statistical analysis performed using the CHI2 test, no statistically significant differences were obtained between the% CV of tacrolimus and the remainder of the variables. The statistical significance in each case was: GFR <60 mL/min (p=0.111), osteoporosis (p=0.202), dyslipidaemia (p=0.353), diabetes (p=0.361), pre-transplant diagnosis (p=0.455), age (p=0.720) and sex (p=0.812).

Conclusion and relevance The% CV of tacrolimus >30% is not related to the appearance of post-transplant complications in a statistically significant way in this cohort of 71 lung transplant patients. There is a positive trend towards the development of kidney failure. More studies are needed and with a larger number of patients to be able to draw more precise conclusions.

Conflict of interest No conflict of interest

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.