Pre-transplant pharmacokinetic profiling and tacrolimus requirements post-transplant

Campbell, S, Hawley, C, Irish, A, Hutchison, B, Walker, R, Butcher, BE and Ferrari, P (2010) Pre-transplant pharmacokinetic profiling and tacrolimus requirements post-transplant. Nephrology, 15 7: 714-719. doi:10.1111/j.1440-1797.2010.01351.x

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Author Campbell, S
Hawley, C
Irish, A
Hutchison, B
Walker, R
Butcher, BE
Ferrari, P
Title Pre-transplant pharmacokinetic profiling and tacrolimus requirements post-transplant
Journal name Nephrology   Check publisher's open access policy
ISSN 1320-5358
1440-1797
Publication date 2010-10
Sub-type Article (original research)
DOI 10.1111/j.1440-1797.2010.01351.x
Volume 15
Issue 7
Start page 714
End page 719
Total pages 6
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2011
Language eng
Formatted abstract
Aim:  To determine the proportion of patients achieving tacrolimus whole-blood concentrations of ≥10 ng/mL within 3 days of kidney transplantation, after randomization either to standard dosing (control group) or post-transplantation dosing guided by a 2-hour (C2) level following a preoperative tacrolimus dose (T2 group).

Methods:  The first postoperative tacrolimus dose was given either according to standard care (control group) or 0.15 mg/kg b.d. if the pre-transplant C2 level was ≤20 ng/mL, 0.1 mg/kg b.d. if the C2 level was 21–59 ng/mL or 0.05 mg/kg b.d. if the C2 level was ≥60 ng/mL (T2 group). Subsequent dosing in both groups was based upon tacrolimus trough level monitoring. Participants received concomitant mycophenolate mofetil and steroids.

Results:  Ninety patients were recruited, of which 84 were included in the analysis (control group n = 43; T2 group n = 41). There was no difference in the proportion of subjects achieving tacrolimus trough levels ≥10 ng/mL (82.9% Control vs 93.0% T2; P = 0.19) or between 10 and 15 ng/mL (41.5% Control vs 41.9% T2; P = 0.97) at day 3 post transplant. The T2 group achieved tacrolimus trough levels of ≥10 ng/mL significantly faster than the control group (100% achievement in 14 days (Control) versus 4 days (T2); P = 0.01).

Conclusion:  Performing a pre-transplant tacrolimus C2 does not significantly increase the high proportion of subjects achieving 10 ng/mL tacrolimus concentrations by day 3 using routine protocols. However, compared with standard care, performing a pre-transplant tacrolimus C2 does lead to patients achieving a whole-blood concentration of ≥10 ng/mL sooner.
© 2010 The Authors
Nephrology © 2010 Asian Pacific Society of Nephrology
Keyword Administration and dosage
Kidney transplantation
Pharmacokinetics
Tacrolimus
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
 
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Created: Mon, 28 Mar 2011, 08:40:12 EST by Lisa Hennell on behalf of !NON-HERDC