Skip to Main Content
 

Global Search Box

 
 
 
 

Files

File List


6721.pdf (244.44 KB)

ETD Abstract Container

Abstract Header

Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients

Claes, Donna
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677

Abstract Details

2013, MS, University of Cincinnati, Medicine: Clinical and Translational Research.
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.
Paul Succop, Ph.D. (Committee Chair)
Jens Goebel, M.D. (Committee Member)
Ahna Pai, Ph.D. (Committee Member)
Erin Nicole Haynes, Dr.P.H. (Committee Member)
29 p.
Surgery
pediatric renal transplantation; non-adherence; donor specific antibodies; immunosuppression drug monitoring

Recommended Citations

Citations

  • Claes, D. (2013). Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients [Master's thesis, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677

    APA Style (7th edition)

  • Claes, Donna. Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients. 2013. University of Cincinnati, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677.

    MLA Style (8th edition)

  • Claes, Donna. "Increased variation in immunosuppressive drug monitoring is associated with the development of donor specific antibodies in pediatric renal transplant recipients." Master's thesis, University of Cincinnati, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1377870677

    Chicago Manual of Style (17th edition)

ucin1377870677
366
© 2013, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.