Variability index of tacrolimus serum levels in pediatric liver transplant recipients younger than 12years: Non-adherence or risk of non-adherence?

Abstract

MLVI has been used to assess adherence. To determine the MLVI in children <12years of age at transplantation and to identify demographic correlates and consequences for the graft. This is a retrospective study of 50 outpatients (4.0±3.5years), at least 13-month post-liver transplantation. The outcomes evaluated were MLVI, ALT>60IU/L, ACR, death, and graft loss. We analyzed demographic and socioeconomic characteristics, indication for transplantation, and type of donor. Student's t test and the chi-square test were used. Statistical significance was set at P≤.05. Seventy-two percent were infants or preschoolers, 62% biliary atresia. Seventy-four percent of the mothers had middle-school education, and 54% of the families had an income ≤3632.4US$/y. Twenty-two (44%) patients had a MLVI≥2 SD; this was more prevalent in families with higher incomes (P=.045). ALT levels>60IU/L were more common in MLVI≥2 SD group (P=.035). ACR episodes were similar between groups (P=1.000). No patient died or lost the graft. MLVI≥2 SD may be an indicator of the risk of medication non-adherence.