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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Tacrolimus remains the cornerstone of immunosuppression after kidney transplantation, but interpatient variability in metabolism complicates dosing. The tacrolimus concentration-to-dose (C0/D) ratio provides a surrogate marker of metabolism: low ratios indicate fast metabolizers at higher risk of toxicity or rejection, while high ratios reflect slower metabolism and more stable exposure. The clinical utility of this ratio across tacrolimus formulations remains underexplored.
We conducted a retrospective cohort study of adult kidney transplant recipients at St. Joseph’s Healthcare Hamilton (2020–2023) We carried out a retrospective study involving adult kidney transplant recipients at St. Joseph’s Healthcare Hamilton from 2020 to 2023 who were on tacrolimus-based immunosuppression. We excluded patients who had received multi-organ transplants or switched to other medications early on. We calculated C0/D ratios at three months and split patients into low and high metabolizer groups based on a cutoff of 1.05. We looked at clinical outcomes like 12-month eGFR, rejection rates, tacrolimus-related kidney damage, and viral infections (specifically BK and CMV). For our analyses, we utilized t-tests, ANOVA, and weighted generalized estimating equations.
Of 674 screened, 397 recipients met inclusion criteria. Faster metabolizers required higher tacrolimus doses to maintain comparable trough levels. At 12 months, eGFR did not differ significantly across metabolizer groups. Patients with low C0/D ratios on Envarsus were often those switched from Advagraf and had lower starting eGFR levels, but after adjustments, kidney function outcomes were comparable across the different formulations. Moreover, survival rates without CMV and BK viremia didn’t show any significant variation (p = 0.235 and p = 0.487, respectively).
Tacrolimus metabolism, reflected by the C0/D ratio, influences dosing requirements but not short-term graft function. No significant differences were found between Envarsus and Advagraf after adjustment. Ongoing data collection aims to validate the C0/D ratio as a practical tool for individualized immunosuppression management.
