17 May 2022>: Original Paper
Tacrolimus-Induced Neurotoxicity in Early Post-Liver Transplant Saudi Patients: Incidence and Risk Factors
Dema A. Alissa 1ABCDEF* , Delal Alkortas 1AE , Mohammed Alsebayel 2AE , Rawan Abdullah Almasuood 3EF , Wejdan Aburas 3EF , Tahani Altamimi 4F , Edward Bentz Devol 5CD , Ahmed H. Al-jedai 16ADEDOI: 10.12659/AOT.935938
Ann Transplant 2022; 27:e935938
Table 1 Baseline characteristics and confounders associated with the development of early calcineurin inhibitor-induced neurotoxicity (ECIIN) using univariate analysis.
All patients (n=338) (percentage) | ECIIN (number (percentage; exact confidence interval)) | P-value | |
---|---|---|---|
No. of female patients | 131 (39%) | 19 (14.5%; 8.96–21.7) | 0.1514 |
No. of living donor transplants | 171 (51%) | 34 (20%; 14.18–26.6) | 0.5787 |
History of hepatic encephalopathy | 99 (29%) | 27 (27%; 18.80–37.15) | |
History of ascites | 142 (42%) | 28 (20%; 13.52–27.22) | 0.6736 |
No. of patients on dialysis before transplantation | 8 (3%) | 3 (38%; 8.52–75.51) | 0.1717 |
ICU admission before transplantation | 77 (23%) | 20 (26%; 16.64–37.23) | 0.0678 |
No. of patients who had re-transplantation | 15 (5%) | 3 (20%; 4.33–48.09) | 1.0000 |
History of hypertension (HTN) | 66 (20%) | 12 (18%; 9.76–29.61) | 1.0000 |
History of diabetes mellitus (DM) | 124 (37%) | 22 (18%; 11.47–25.62) | 0.7741 |
History seizures | 4 (1%) | 2 (50%; 6.76–93.24) | 0.1593 |
Hepatic cellular carcinoma (HCC) | 92 (27%) | 11 (12%; 6.12–20.39) | 0.0600 |
No. of patients who needed re-operation within 4 weeks after transplant | 55 (16%) | 20 (36%; 23.81–50.44) | |
No. of patients who had basiliximab induction | 134 (40%) | 28 (21%; 14.36–28.76) | 0.3952 |
No. of patients with mean arterial pressure (MAP) | 79 (23%) | 10 (13%; 6.24–22.05) | 0.1386 |
No. of patients who had dialysis post-transplant | 21 (6%) | 8 (38%; 18.11–61.56) | |
Hepatitis C virus (HCV) | 135 (40%) | 20 (15%; 9.29–21.95) | 0.1556 |
Hepatitis B virus (HBV) | 80 (24%) | 15 (19%; 10.89–29.03) | 1.0000 |
Cryptogenic | 62 (18%) | 12 (19%; 10.42–31.37) | 0.8579 |
Autoimmune hepatitis (AIH) | 41 (12%) | 13 (32%; 18.08–48.09) | |
Non-Alcoholic Fatty Liver Disease | 17 (5%) | 6 (35%; 14.21–61.67) | 0.1020 |
Primary sclerosing cholangitis (PSC) | 10 (3%) | 2 (20%; 2.52–55.61) | 1.0000 |
Schistosomiasis | 11 (3%) | 1 (9%; 0.23–41.28) | 0.6966 |
Primary Biliary Cirrhosis | 7 (2%) | 1 (14%; 0.36–57.87) | 1.0000 |
Fulminant hepatitis | 6 (2%) | 2 (33%; 4.33–77.72) | 0.3110 |
Budd-Chiari | 7 (2%) | 2 (29%; 3.67–70.96) | 0.6186 |
Alcoholic liver disease | 4 (2%) | 1 (25%; 0.63–80.59) | 0.5636 |
Others | 5 (2%) | 0 (0%; 0–52.18) | 1.0000 |
Developed CMV infection post-transplantation | 55 (16%) | 15 (27%; 16.14–40.96) | 0.0879 |
Developed sepsis post-transplantation | 56 (17%) | 28 (50%; 36.34–63.66) | |
Developed DM post-transplantation | 127 (38%) | 26 (20%; 13.83–28.54) | 0.5644 |
Developed HTN post-transplantation | 120 (36%) | 25 (21%; 13.96–29.20) | 0.4673 |
Height (cm) | 163 (157.3–169) | 162 (158.5–168.5) | 0.9061 |
Weight (kg) | 69.8 (59.1–79.08) | 73.3 (58.65–81.85) | 0.4077 |
BMI (kg/m) | 25.67 (23.12–29.09) | 27.59 (23.25–30.30) | 0.3546 |
Age (years) | 53.58 (44.57–59.81) | 53.24 (45.7–59.45) | 0.6022 |
MELD score | 19.5 (15–25) | 22 (18–29.5) | |
SrCr (mmol/L) | 77 (60.25–105.75) | 79 (64.5–108) | 0.7658 |
Mg (mmol/L) | 0.73 (0.63–0.83) | 0.72 (0.62–0.85) | 0.9215 |
Na (mmol/L) | 139 (134–142) | 139 (133–143) | 0.8682 |
Ca (mmol/L) | 2.11 (1.98–2.24) | 2.12 (1.96–2.28) | 0.8372 |
Albumin (g/L) | 29.3 (25.1–34) | 30.6 (24.6–35.55) | 0.6290 |
Ca corrected (mmol/L) | 2.3 (2.21–2.4) | 2.29 (2.19–2.39) | 0.3584 |
Cholesterol (mmol/L) | 3 (2.1–3.6) | 3 (1.75–3.55) | 0.7815 |
HDL (mmol/L) | 0.83 (0.44–1.18) | 0.62 (0.34–1.01) | 0.2760 |
Triglyceride (mmol/L) | 0.85 (0.65–1.15) | 0.95 (0.7–1.29) | 0.2080 |
LDL (mmol/L) | 1.62 (1.01–2) | 1.6 (1.06–2.11) | 0.4404 |
Warm ischemia time (Hr) | 0.76 (0.57–0.95) | 0.74 (0.64–0.97) | 0.9618 |
Cold ischemia time (Hr) | 3.06 (2.12–4.58) | 2.75 (2.19–4.65) | 0.7445 |
Total ischemia time (Hr) | 3.8 (3.09–5.44) | 3.49 (3.15–4.89) | 0.5664 |
Units of Packed Red Blood Cells | 5 (4–9.25) | 5.5 (4–11) | 0.2289 |
Units of Fresh Frozen Plasma | 4 (0–9.5) | 6 (1–10) | |
Units of Platelets | 2 (0–6.75) | 5 (0–9) | 0.1225 |
SrCr (mmol/L) | 77 (61–101) | 81 (59–99) | 0.8015 |
Mg (mmol/L) | 0.67 (0.53–0.90) | 0.65 (0.51–0.92) | 0.9034 |
Na (mmol/L) | 143 (140–147) | 145 (141.5–148) | |
Ca (mmol/L) | 2.07 (1.94–2.26) | 2.1 (1.97–2.31) | 0.2945 |
Albumin (g/L) | 27.1 (23.85–31) | 27 (23.6–31) | 0.6085 |
Ca corrected (mmol/L) | 2.33 (2.19–2.50) | 2.38 (2.24–2.52) | 0.1290 |
Tacrolimus steady-state levels (ng/ml) | 4 (2.9–6.45) | 5.05 (2.83–7.45) | 0.1484 |