Medication level variability index predicts rejection, possibly due to nonadherence, in adult liver transplant recipients

摘要: Nonadherence to immunosuppressants may play a role in late rejection liver transplant recipients. In children, emerging data suggest that adherence can be measured through the computation of standard deviation (SD) consecutive blood levels tacrolimus, which results number reflects degree variability between individual measures: medication level index (MLVI). A higher MLVI value means erratic immunosuppression, likely due less adherence. Data on this method are limited for adults. We obtained from medical charts 150 randomly selected adult The was significantly patients who had biopsy-confirmed (mean MLVI = 3.8, SD = 3.2) versus rest cohort MLVI = 2.3, SD = 1.5, P = 0.003), and it suffered whose biopsy sample not read as MLVI = 2.6, SD = 1.6, P = 0.008). associated with predicted its occurrence. threshold 2.0 resulted 77% sensitivity 60% specificity predicting rejection; 1.8 92% 48%. area under curve receiver operating characteristic analysis 0.71 (95% CI = 0.61-0.81). conclusion, is predict rejection, possibly related nonadherence, Liver Transpl 20:1168–1177, 2014. © 2014 AASLD.