BACKGROUND: The variability of @entity1140 blood levels has been shown to be associated with inferior graft survival. However, the effect of variability during the early post-transplantation period has not been evaluated. We sought to evaluate the association between time-weighted variability in the early post-transplantation period and graft survival. We also explored the interaction between drug level variability and exposure to inadequate drug levels. METHODS: This retrospective cohort study included all @entity1 who underwent kidney transplantation in the Rabin Medical Center and were treated with @entity1140 . Time-weighted coefficient of variability (TWCV) was defined as time-weighted standard deviation divided by the mean drug level. Univariate and multivariate Cox proportional hazard model was used with the primary outcome of @entity1 and graft survival. RESULTS: The study population included 803 @entity1 who underwent kidney transplantation between 1 January 2000 and 29 September 2013. The high tertile of TWCV of @entity1140 blood levels was associated with reduced graft survival by univariate and multivariate analyses [hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.14-2.53, P   =   0.01 and HR 1.74, 95% CI 1.14-2.63, P   =   0.01, respectively]. The interaction between high TWCV and exposure to inadequately low drug levels was significantly associated with reduced survival (P   =   0.004), while the interaction between TWCV and high drug blood levels was not. One hundred and thirty @entity1 (16.2%) had the combination of high TWCV and exposure to low drug values (<5   ng/mL). These @entity1 had reduced graft survival by univariate and multivariate analyses (HR 2.42, 95% CI 1.57-3.74, @entity353 .6, 95% CI 1.65-4.11, P   <   0.001, respectively). CONCLUSIONS: The combination of high TWCV and exposure to low drug levels might identify high-risk @entity1 in the early post-transplantation period.

Association of the combination of time-weighted variability of XXXX blood level and exposure to low drug levels with graft survival after kidney transplantation.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity353 :: ('MESH:D015431', 'Disease') :: ['P   <   0.001 and HR 2'] @entity1140 :: ('MESH:D016559', 'Chemical') :: ['tacrolimus']
@entity1140 :: (MESH:D016559,Chemical) :: ['tacrolimus']
