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- W3208680204 abstract "Purpose: The importance of immunosuppressant blood dosage in a transplant patient is widely recognized for detecting the immunosuppressive capacity.In case of Tacrolimus in liver recipients,the drug excretion is carried out by the transplanted graft itself.The aim of the“Tacrolimus in Bile”(TUBE)Trial is the creation of a laboratory parameter for the early detection of hepatic injury after liver transplant Method: TUBE is a single-blind prospective monocentric trial,in which liver recipients who had Kehr's tube inserted into the biliary tract were enrolled.In the first 10 post-operative days (POD),a bile sample was collected together with a blood sample.The blood and biliary values of Tacrolimus were correlated to create theblood-bile ratio of Tacrolimus(BBRT).The primary outcome was the assessment of the predictive ability of BBRT in the evaluation of liver rejection injury,diagnosed through laboratory or pathological analysis.The relationship between BBRT and liver injury was examined through a Wilcoxon-Mann-Whitney test.A ROC curve was developed to estimate the BBRT threshold with the best sensitivity/specificity ratio Results: Among the 35 patients enrolled,12(34%) presented with acute rejection liver injury,diagnosed by standard methods between the 5thand 7thPOD.Transaminases,total bilirubin and blood tacrolimus levels did not differ significantly in the two study patient groups,unlike eosinophils within the rejection period.The mean BBRT value presented a significant difference between the two study groups already in the 4thPOD(p=0.026)(Figure 1).The ROC curve confirmed the statistical significance of BBRT(p=0.018).The sensitivity and specificity achieved with a BBRT cut-off value of 4.1 was 75% and 74%,respectively Conclusions: The early diagnosis of acute rejection liver injury allows an improvement in the overall transplant outcome.The TUBE trial is the first study evaluating the relationship between blood and biliary concentrations of a marker with hepatic excretion in liver transplant patients.This research field can be deepened by considering other aspects,such as liver enzyme polymorphism or blood flow alterations to the graft.To date,BBRT can be considered an additional laboratory marker for detecting liver rejection damage after liver transplantation." @default.
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- W3208680204 date "2021-01-01" @default.
- W3208680204 modified "2023-10-18" @default.
- W3208680204 title "Analysis of biliary tacrolimus for the detection of hepatic rejection injury" @default.
- W3208680204 doi "https://doi.org/10.1016/j.hpb.2021.08.198" @default.
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