Pharmacokinetics Of Immunosuppressants Among Young, Middle, And Elderly Kidney Transplant Recipients: Its Impact For Clinical Outcomes

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-18 PHARMACOKINETICS OF IMMUNOSUPPRESSANTS AMONG YOUNG, MIDDLE, AND ELDERLY KIDNEY TRANSPLANT RECIPIENTS: ITS IMPACT FOR CLINICAL OUTCOMES Ryuichiro Sagehashi, Mitsuru Saito, Takuro Saito, Ryohei Yamamoto, Nobuhiro Fujiyama, Souki Kashima, Atsushi Koizumi, Taketoshi Nara, Kazuyuki Numakura, Shintaro Narita, Shigeru Satoh, and Habuchi Tomonori Ryuichiro SagehashiRyuichiro Sagehashi More articles by this author , Mitsuru SaitoMitsuru Saito More articles by this author , Takuro SaitoTakuro Saito More articles by this author , Ryohei YamamotoRyohei Yamamoto More articles by this author , Nobuhiro FujiyamaNobuhiro Fujiyama More articles by this author , Souki KashimaSouki Kashima More articles by this author , Atsushi KoizumiAtsushi Koizumi More articles by this author , Taketoshi NaraTaketoshi Nara More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Shintaro NaritaShintaro Narita More articles by this author , Shigeru SatohShigeru Satoh More articles by this author , and Habuchi TomonoriHabuchi Tomonori More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We investigated that pharmacokinetics of immunosuppressants among young, middle, and elderly kidney transplant recipients and its impact for clinical outcomes. METHODS: A total of 179 pairs of recipients and donors who underwent living kidney transplantation in our institute between November 2009 and April 2019 were enrolled in this study. Recipients were divided into three groups according to age at transplantation: the young (<55 years, 98 patients), middle-aged (55–64 years, 54 patients), and elderly groups (≥65 years, 27 patients). All recipients received the combination therapy, consisting of tacrolimus (TAC), mycophenolate mofetil (MMF), prednisolone (PSL), and basiliximab. Moreover, from October 2013, everolimus (EVR) was added and TAC and MMF doses were reduced after 14 postoperative days. In immunologically high-risk patients, single dose of rituximab at 200 mg/body was administered and 1–4 sessions of antibody removal were performed before transplantation. Doses of immunosuppressants were not arranged according to age of recipients. RESULTS: The age of donor in the elderly group was significantly higher than the other groups (p<0.01, respectively); however, no significant difference in the donors’ renal function was observed among groups. Immunologically high-risk patients in the middle-aged and elderly groups were significantly higher than that in the young group (p=0.01, respectively). In the pharmacokinetic analysis, no significant differences in trough levels and AUC of TAC, MPA, and EVR, were observed among the groups. No infectious death was observed in this cohort, and incidences of hospitalization for infectious events did not differ among groups. In addition, incidences of rejection and de novo malignancies between the young and elderly groups were similar. No significant difference of the death censored graft survival was observed among groups. CONCLUSIONS: In the modern immunosuppressive protocol, the aging process itself may have little effect on the pharmacokinetics of immunosuppressants. It may be necessary to refrain from easy dose reduction of immunosuppressants in elderly kidney transplant recipients . Source of Funding: We have no financial relationships to disclose. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e653-e653 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryuichiro Sagehashi More articles by this author Mitsuru Saito More articles by this author Takuro Saito More articles by this author Ryohei Yamamoto More articles by this author Nobuhiro Fujiyama More articles by this author Souki Kashima More articles by this author Atsushi Koizumi More articles by this author Taketoshi Nara More articles by this author Kazuyuki Numakura More articles by this author Shintaro Narita More articles by this author Shigeru Satoh More articles by this author Habuchi Tomonori More articles by this author Expand All Advertisement PDF downloadLoading ...