Oral Tacrolimus Bioavailability Is Increased After Right Split Liver Transplantation

Wilberg, J.; Küpper, B.; Thrum, Katharina; Barthel, Erik R.; Koch, A.; Settmacher, Utz; Kornberg, Arno

doi:10.1016/j.transproceed.2007.03.102

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Although a total of 12 patients per treatment arm were deemed sufficient for this analysis, the study population was smaller than previous studies of the PKs of tacrolimus. It has previously been shown that tacrolimus bioavailability was significantly higher after partial liver transplant compared with full transplants, and the volume of the split liver should be used to calculate the more appropriate dose of tacrolimus . However, this study did not examine the effects of split liver grafts on the PKs of tacrolimus.…”

Section: Discussionmentioning

confidence: 96%

Pharmacokinetics of prolonged‐release tacrolimus versus immediate‐release tacrolimus in de novo liver transplantation: A randomized phase III substudy

Ericzon

Varó

Trunečka

et al. 2017

Clinical Transplantation

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Doubling the initial starting dose of prolonged-release tacrolimus compared with immediate-release tacrolimus overcompensated for lower exposure on Day 1. A 50% higher starting dose of prolonged-release tacrolimus than immediate-release tacrolimus may be required for similar systemic exposure. However, doses of both formulations can be optimized using the same trough-level monitoring system. (ClinicalTrials.gov number: NCT00189826).

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Section: Discussionmentioning

confidence: 96%

Pharmacokinetics of prolonged‐release tacrolimus versus immediate‐release tacrolimus in de novo liver transplantation: A randomized phase III substudy

Ericzon

Varó

Trunečka

et al. 2017

Clinical Transplantation

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“…This is clearly a predominantly paediatric problem given that split grafts are frequently used whether from deceased or living donors, and that the donor/recipient weight ratio varies with each donor/recipient pair. In addition, issues with diet and absorption is probably a major confounder, something which is difficult to control for and model [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Immunosuppressant therapeutic drug monitoring and trough level stabilisation after paediatric liver or kidney transplantation

et al. 2019

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BACKGROUND: Immunosuppressive therapy must be guided by therapeutic drug monitoring (TDM) in paediatric liver (LT) and kidney transplantation (KT) patients to prevent under-and overdosing, which have clinical consequences.AIM: The purpose of our study was to analyse TDM results in our institutions and evaluate factors associated with blood level stabilisation after LT and KT.METHODS: Blood levels of immunosuppressants were measured by immunoassay analysis. We compared blood level stabilisation between LT and KT, and evaluated associated factors in a retrospective study in two Swiss university hospitals.RESULTS: Forty-six patients (27 LT [median age 1.0 y], 19 KT [15.1 y]) were included. During the first month after transplantation, 32.8% (LT) and 41.2% (KT) of tacrolimus, and 22.1% (KT) of ciclosporin trough levels (measured before the next dose) were within target. In KT, trough levels stabilised earlier for tacrolimus than for ciclosporin (p = 0.02). Intensive care and hospital discharge occurred earlier in KT patients (p <0.001). Living-donor LT was associated with an earlier intensive care discharge compared with deceased donor (5.5 vs 11 days, p = 0.02). Primary metabolic disease and graft/recipient weight-ratio ≥0.03 was associated with earlier tacrolimus level stabilisation (14 vs 18 days, p = 0.01 and 15 vs 22 days, p = 0.05, respectively). In KT, recipient age (≥15.1 years) and weight (≥39.4 kg) were associated with an earlier trough level sta-bilisation (both 13 days vs not reached, p <0.001), and age with earlier hospital discharge (10 vs 14 days, p = 0.02).CONCLUSION: Immunosuppressant trough levels were often outside the target range in the first month after LT and KT. Organ-specific factors were associated with trough stabilisation.

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Oral Tacrolimus Bioavailability Is Increased After Right Split Liver Transplantation

Cited by 2 publications

References 5 publications

Pharmacokinetics of prolonged‐release tacrolimus versus immediate‐release tacrolimus in de novo liver transplantation: A randomized phase III substudy

Pharmacokinetics of prolonged‐release tacrolimus versus immediate‐release tacrolimus in de novo liver transplantation: A randomized phase III substudy

Immunosuppressant therapeutic drug monitoring and trough level stabilisation after paediatric liver or kidney transplantation

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