Tacrolimus intrapatient variability and latent virus reactivation after kidney transplantation: A retrospective study comparing prolonged-release and immediate-release tacrolimus formulations
Journal of International Medical Research, cilt.54, sa.7, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 54 Sayı: 7
- Basım Tarihi: 2026
- Doi Numarası: 10.1177/03000605261465991
- Dergi Adı: Journal of International Medical Research
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Directory of Open Access Journals, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Anahtar Kelimeler: Kidney transplantation, tacrolimus intrapatient variability, tacrolimus formulations, latent viral infections, BK virus, cytomegalovirus
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: This study explored the differences in intrapatient variability of tacrolimus between prolonged-release and immediate-release formulations and evaluated the association between tacrolimus intrapatient variability and reactivation of BK virus and cytomegalovirus in kidney transplant recipients. Methods: This retrospective observational study included 270 kidney transplant recipients receiving either prolonged-release tacrolimus or immediate-release tacrolimus. Receiver operating characteristic curve analysis identified tacrolimus intrapatient variability cutoff values associated with viral reactivation. Logistic regression analyses identified predictors of BK virus and cytomegalovirus reactivation. Results: The prolonged-release tacrolimus group had significantly lower tacrolimus intrapatient variability than the immediate-release tacrolimus group (p < 0.001). No significant differences were observed in BK virus and cytomegalovirus reactivation rates. Receiver operating characteristic curve analysis identified tacrolimus intrapatient variability cutoffs of 0.268 for BK virus and 0.261 for cytomegalovirus. High tacrolimus intrapatient variability was significantly associated with increased BK virus and cytomegalovirus reactivation. Logistic regression showed that high tacrolimus intrapatient variability was significantly associated with BK virus and cytomegalovirus reactivation. Multivariate analysis confirmed an independent association between high tacrolimus intrapatient variability and cytomegalovirus reactivation. Conclusions: Tacrolimus intrapatient variability may predict reactivation of latent viral infection after kidney transplantation. Although viral reactivation rates were similar between tacrolimus formulations, prolonged-release tacrolimus showed lower tacrolimus intrapatient variability levels, suggesting that fluctuations in tacrolimus exposure might increase the risk of viral reactivation.