Correlation between graft size and necessary tacrolimus dose after living-related liver transplantation

Harihara, Yasushi; Sano, Kazuya; Makuuchi, Masatoshi; Kawarasaki, Hideo; Takayama, T.; Kubota, Keiichi; Ito, Mitsuhiro; Mizuta, Koichi; Yoshino, Hiroyuki; Hirata, Masaaki; Kita, Yoshiaki; Hisatomi, S; Kusaka, K; Miura, Yoshiko; Hashizume, Kohei

doi:10.1016/s0041-1345(00)01618-3

Cited by 8 publications

(5 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The impact of maturation was more difficult to assess as tacrolimus clearance in paediatric liver transplant recipients is the result of a complex interplay between the recipient's and the donor's characteristics. These characteristics include the following: (i) the recipient's intestinal metabolism and transporter activity, which are influenced at least by maturation and the recipent's CYP3A5 and possibly by ABCB1 gene polymorphisms; (ii) the donor's hepatic metabolism, which depends at least on the donor's age and CYP3A5 genotype; and (iii) the ratio of the graft size to the recipient's bodyweight and to the recipient's standard liver volume . Also, the influence of the recipient's age on the metabolic capacity of the transplanted liver is currently unknown.…”

Section: Discussionmentioning

confidence: 99%

Population pharmacokinetics and Bayesian estimation of tacrolimus exposure in paediatric liver transplant recipients

Kassir

Labbé

Delaloye

et al. 2014

Br J Clin Pharmacol

View full text Add to dashboard Cite

AIMSThe objectives of this study were to develop a population pharmacokinetic (PopPK) model for tacrolimus in paediatric liver transplant patients and determine optimal sampling strategies to estimate tacrolimus exposure accurately. METHODSTwelve hour intensive pharmacokinetic profiles from 30 patients (age 0.4-18.4 years) receiving tacrolimus orally were analysed. The PopPK model explored the following covariates: weight, age, sex, type of transplant, age of liver donor, liver function tests, albumin, haematocrit, drug interactions, drug formulation and time post-transplantation. Optimal sampling strategies were developed and validated with jackknife.

show abstract

Section: Discussionmentioning

confidence: 99%

Population pharmacokinetics and Bayesian estimation of tacrolimus exposure in paediatric liver transplant recipients

Kassir

Labbé

Delaloye

et al. 2014

Br J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…We started our living donor liver transplantation (LDLT) program in January 1996, using FK and methylprednisolone as basic immunosuppressants (2). In our experience, FK shows wide interpatient variation with regard to the dose needed to achieve an appropriate blood level (3). The aim of this study was to assess the relationship between the optimal FK dose and clinical factors and to derive an equation to predict the optimal FK dose in LDLT.…”

mentioning

confidence: 96%

Correlation between optimal tacrolimus doses and the graft weight in living donor liver transplantation

Sugawara

Makuuchi

Kaneko

et al. 2002

Clinical Transplantation

Self Cite

View full text Add to dashboard Cite

The optimal doses of tacrolimus (FK) needed to reach and maintain a target blood level vary among cases of living donor liver transplantation (LDLT). One hundred and twenty four LDLTs in 122 patients were included in this study. Tacrolimus was administered by continuous intravenous infusion at a rate of 2.5 microg/kg/h just after the operation. The time needed to reach the target blood level and the dose needed to maintain this level for 1 week (17-18 ng/mL) were defined as the initial duration (ID) and secondary dose (SD), respectively. In the first 100 LDLTs, the correlations between ID or SD and some clinical factors were examined and equations for predicting ID or SD were derived. In the latest 24 LDLTs, FK was administered using these equations and the actual and calculated ID and SD values were compared. A multiple regression analysis revealed that only the graft weight/recipient standard liver volume (GW/SLV) ratio (%) correlated with ID or SD. Stepwise regression analysis led to the equations ID (h) = 0.4 x GW/SLV ratio + 0.2; SD (microg/kg/h) = 0.02 x GW/SLV ratio - 0.4. Simple regression analysis revealed a significant correlation between the actual and calculated ID and SD values (p < 0.0001). Initial duration and SD can be estimated from equations using the GW/SLV ratio.

show abstract

“…Graft function might affect the optimal tacrolimus dose and its pharmacokinetics. The Shinsyu group (9) and Harihara et al (10) reported that donors whose GV/SV ratio had been estimated to be more than 30% were acceptable. In recent years, LDLT in adult patients with small-for-size grafts has become increasingly accepted.…”

Section: Discussionmentioning

confidence: 99%

Influence of continuous venovenous haemodiafiltration on the pharmacokinetics of tacrolimus in liver transplant recipients with small‐for‐size grafts

Kishino

Takekuma

Sugawara

et al. 2003

Clinical Transplantation

View full text Add to dashboard Cite

In adult-to-adult living donor liver transplantation (LDLT), the graft volume is inevitably much smaller than the ideal liver mass (standard liver volume) for the recipient's metabolic demand. Patients with small-for-size grafts are treated with continuous venovenous haemodiafiltration (CVVHD) for the artificial liver support. However, little is known about the influence of CVVHD on the elimination of tacrolimus. The objective of this study was to elucidate the effect of CVVHD on the pharmacokinetics of tacrolimus in recipients of LDLT with small-for-size grafts. Three liver transplant recipients (one male and two females) and donors (two males and one female) were enrolled in this study. Blood samples from inflow port and outflow port were obtained on the first day at the start of CVVHD. Whole-blood concentrations of tacrolimus were measured immediately using the microparticle enzyme immunoassay (MEIA; Abbott Laboratories). There was no significant difference between concentrations of tacrolimus in blood sampled at inflow port and outflow port sites and t(1/2)-values of tacrolimus in the three recipients were 29.9, 63.6 and 28.8 h. CVVHD did not cause a decrease in the blood tacrolimus concentration. Adjustment to the dose or dosing interval is not required for patients treated with tacrolimus during CVVHD.

show abstract

Correlation between graft size and necessary tacrolimus dose after living-related liver transplantation

Cited by 8 publications

References 4 publications

Population pharmacokinetics and Bayesian estimation of tacrolimus exposure in paediatric liver transplant recipients

Population pharmacokinetics and Bayesian estimation of tacrolimus exposure in paediatric liver transplant recipients

Correlation between optimal tacrolimus doses and the graft weight in living donor liver transplantation

Influence of continuous venovenous haemodiafiltration on the pharmacokinetics of tacrolimus in liver transplant recipients with small‐for‐size grafts

Contact Info

Product

Resources

About