01 January 2008
Therapeutic Drug Monitoring of tacrolimus in renal transplant patients
B. Solnica, K. Słowińska-Solnica, E. Ignacak, J. W. NaskalskiAnn Transplant 2008; 13(1): 39-40 :: ID: 880202
Abstract
Background: The aim of this study was the retrospective evaluation of the relationship between the dosage of tacrolimus and its blood concentrations in renal transplant patients and assessment of the relationship between blood drug levels and the pharmacological effect.
Material/Methods: The studied group consisted of 64 patients (42 men and 22 women) on combined immunosuppressive treatment using tacrolimus (T), prednisolone (P), mycophenolate (M), azthioprine (A) and sirolimus (S) in various combinations including tacrolimus. The tacrolimus doses ranged from 0.05 to 0.3 mg/kg/day. During the 32-42 weeks follow-up whole blood tacrolimus levels were measured with microparticle enzyme immunoassay on IMx analyzer.
Results: No significant correlation between tacrolimus doses and its blood concentrations was found. Drug levels were within the subtherapeutic range in 89.1% of patients during the entire follow-up. In remaining patients 75-92.3% of results were also subtherapeutic, less than 25% of results were in the therapeutic range, no toxic levels were obtained. The graft rejection was observed in 10.9% patients, men only, 6 on T-P-M treatment (15.8% of T-P-M group) and one on T-P-A treatment. Acute tubular necrosis was observed in
21.9% of patients, 9 men (8 on T-P-M and 1 on T-P-A treatment) and 5 women (2 on T-P-M, 2 on T-P-A and 1 on T-P treatment). All graft rejections and ATN episodes occurred with sub-therapeutic tacrolimus concentrations. Conclusions: No significant dose-concentrations relationship indicates the need for individualized, empiric dosage and therapeutic monitoring of tacrolimus. In majority of studied patients the combined immunosupressive treatment including tacrolimus in subtherapeutic blood levels was effective. Thus, separate therapeutic ranges should be established for combined treatment and for both sexes. On the other hand subtherapeutic drug levels were found in all patients with graft rejection. However, these rejection episodes can not be explained solely by sub-therapeutic tacrolimus concentrations.
Keywords: Tacrolimus, mycophenolate, Cytocheratin 7
In Press
08 Mar 2024 : Original article
Association of Coronary Calcium Score on Cardiac PET During Pre-Kidney Transplant Assessment with Persisten...Ann Transplant In Press; DOI: 10.12659/AOT.943532
14 Mar 2024 : Original article
Impact of Blood Products Transfusion on Patients in the Immediate Post-Lung Transplant Period: A Cohort StudyAnn Transplant In Press; DOI: 10.12659/AOT.943652
14 Mar 2024 : Case report
Treatment of Cavernous Transformation of Portal Vein Caused by Hepatic Cystic Echinococcosis Using Ex Vivo ...Ann Transplant In Press; DOI: 10.12659/AOT.942358
15 Mar 2024 : Review article
Approaches and Challenges in the Current Management of Cytomegalovirus in Transplant Recipients: Highlighti...Ann Transplant In Press; DOI: 10.12659/AOT.941185
Most Viewed Current Articles
05 Apr 2022 : Original article
Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver TransplantationDOI :10.12659/AOT.935604
Ann Transplant 2022; 27:e935604
12 Jan 2022 : Original article
Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...DOI :10.12659/AOT.934738
Ann Transplant 2022; 27:e934738
22 Nov 2022 : Original article
Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...DOI :10.12659/AOT.937988
Ann Transplant 2022; 27:e937988
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860