Tacrolimus pharmacokinetics in heart transplant

Sgrosso, J. L.; Araujo, Graciela; Vazquez, M. C.

doi:10.1016/s0041-1345(01)02706-3

Cited by 12 publications

(4 citation statements)

References 2 publications

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“…C0 was found to correlate with 12-hour AUC and is standard practice for drug monitoring. 14 Several studies in liver, 9,15 renal, 16 and most recently, heart transplantation 6,8 have challenged the concept, showing highly variable drug exposure and sub-optimal correlation of C0 with AUC 0 -12 .…”

Section: Discussionmentioning

confidence: 99%

Tacrolimus Pharmacokinetics in Lung Transplantation: New Strategies for Monitoring

Ragette

Kamler

Weinreich

et al. 2005

The Journal of Heart and Lung Transplantation

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Section: Discussionmentioning

confidence: 99%

Tacrolimus Pharmacokinetics in Lung Transplantation: New Strategies for Monitoring

Ragette

Kamler

Weinreich

et al. 2005

The Journal of Heart and Lung Transplantation

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“…Although tacrolimus C 0 concentrations are generally considered to be a good indication of the total systemic drug exposure [ 1 , 8 ], its usefulness in differentiating graft rejection episodes from nephrotoxicity has been questioned [ 6 , 9 – 11 ]. Recently, the correlation between individual tacrolimus concentrations and AUC 0–12 has been studied in kidney [ 12 – 18 ], liver [ 19 ], heart [ 20 , 21 ] and lung [ 22 ] transplant recipients. In these studies, a poor association was found between the tacrolimus C 0 concentrations and the AUC 0–12 , while tacrolimus concentrations measured at other time points showed much better correlations with the AUC 0–12 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of limited sampling strategies for tacrolimus

Buijsch

Plas

Stolk

et al. 2007

Eur J Clin Pharmacol

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Objective In literature, a great diversity of limited sampling strategies (LSS) have been recommended for tacrolimus monitoring, however proper validation of these strategies to accurately predict the area under the time concentration curve (AUC 0-12 ) is limited. The aim of this study was to determine whether these LSS might be useful for AUC prediction of other patient populations. Methods The LSS from literature studied were based on regression equations or on Bayesian fitting using MWPHARM 3.50 (Mediware, Groningen, the Netherlands). The performance was evaluated on 24 of these LSS in our population of 37 renal transplant patients with known AUCs. The results were also compared with the predictability of the regression equation based on the trough concentrations C 0 and C 12 of these 37 patients. Criterion was an absolute prediction error (APE) that differed less than 15% from the complete AUC 0-12 calculated by the trapezoidal rule. Results Thirteen of the 18 (72%) LSS based on regression analysis were capable of predicting at least 90% of the 37 individual AUC 0-12 within an APE of 15%. Additionally, all but three LSS examined gave a better prediction of the complete AUC 0-12 in comparison with the trough concentrations C 0 or C 12 (mean 62%). All six LSS based on Bayesian fitting predicted <90% of the 37 complete AUC 0-12 correctly (mean 67%). Conclusions The present study indicated that implementation of LSS based on regression analysis could produce satisfactory predictions although careful evaluation is necessary.

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“…CNIs therefore weaken the immune response to foreign antigens. Noteworthy, CNI agents have a narrow therapeutic range and not only show a wide interindividual variability in pharmacokinetics, 25 but their level is also affected by concomitant medications, such as antifungals. See Table 2 for additional drug‐drug interactions.…”

Section: Post‐transplant Maintenance Immunosuppressionmentioning

confidence: 99%

Pharmacotherapy in the heart transplant recipient: A primer for nurse clinicians and pharmacists

Fraser,

Page,

Chow

et al. 2024

Clinical Transplantation

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Heart transplantation (HT) is the definitive treatment for eligible patients with end‐stage heart disease. A major complication of HT is allograft rejection which can lead to graft dysfunction and death. The guiding principle of chronic immunosuppression therapy is to prevent rejection of the transplanted organ while avoiding oversuppression of the immune system, which can cause opportunistic infections and malignancy. The purpose of this review is to describe immunosuppressive management of the HT recipient—including agent‐specific pharmacology and pharmacokinetics, outcomes data, adverse effects, clinical considerations, and recent guideline updates. We will also provide recommendations for medical prophylaxis of immunosuppressed patients based on the most recent clinical guidelines. Additionally, we highlight the importance of medical therapy adherence and the effect of social determinants of health on the long‐term management of HT. HT recipients are a complex and high‐risk population. The objective of this review is to describe basic pharmacotherapy in HT and implications for nurses and pharmacists.

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Tacrolimus pharmacokinetics in heart transplant

Cited by 12 publications

References 2 publications

Tacrolimus Pharmacokinetics in Lung Transplantation: New Strategies for Monitoring

Tacrolimus Pharmacokinetics in Lung Transplantation: New Strategies for Monitoring

Evaluation of limited sampling strategies for tacrolimus

Pharmacotherapy in the heart transplant recipient: A primer for nurse clinicians and pharmacists

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