Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients
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University of Cincinnati / OhioLINK
2013
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| Online Access: | http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677 |
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ndltd-OhioLink-oai-etd.ohiolink.edu-ucin13778706772021-08-03T06:19:39Z Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients Claes, Donna Surgery pediatric renal transplantation non-adherence donor specific antibodies immunosuppression drug monitoring Previous studies associating non-adherence with donor specific antibodies (DSA) development in renal transplant recipients have used subjective assessments to classify non-adherence. No studies have examined the association between objective measures of non-adherence – primarily, standard deviation and/or coefficient of variation of immunosuppressive drug levels - and DSA development. We retrospectively analyzed the standard deviation and coefficient of variation in the five most recent tacrolimus or sirolimus trough drug levels at the time of DSA testing in 69 low-to-standard immunologic risk, first-time pediatric renal transplant recipients followed at a single US pediatric nephrology center. DSA prevalence in the population was 38% (n=26). DSA+ patients had significantly higher standard deviation (p=0.014) and coefficient of variation (p=0.024). There was a trend towards increased DSA prevalence in patients taking sirolimus vs. tacrolimus (p=0.14). Multivariate logistic regression demonstrated that coefficient of variation (p = 0.03) and black race (p=0.012) retained statistical significance in DSA development. For each 10% increase in coefficient of variation, the odds of developing a DSA increased by almost 40% (adj OR 1.38, 95% CI 1.09, 1.75). Future studies are needed to understand the extent and length of time variations in immunosuppressant medications that are tolerated prior to DSA formation. 2013-10-28 English text University of Cincinnati / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677 http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
| collection |
NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Surgery pediatric renal transplantation non-adherence donor specific antibodies immunosuppression drug monitoring |
| spellingShingle |
Surgery pediatric renal transplantation non-adherence donor specific antibodies immunosuppression drug monitoring Claes, Donna Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients |
| author |
Claes, Donna |
| author_facet |
Claes, Donna |
| author_sort |
Claes, Donna |
| title |
Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients |
| title_short |
Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients |
| title_full |
Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients |
| title_fullStr |
Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients |
| title_full_unstemmed |
Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients |
| title_sort |
increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients |
| publisher |
University of Cincinnati / OhioLINK |
| publishDate |
2013 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677 |
| work_keys_str_mv |
AT claesdonna increasedvariationinimmunosuppressivedrugmonitoringisassociatedwiththedevelopmentofdonorspecificantibodiesinpediatricrenaltransplantrecipients |
| _version_ |
1719434731756453888 |