48045
document
Pre-transplant pharmacokinetic profiling and tacrolimus requirements post-transplant . 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 ( C ( 2 ) ) 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 C ( 2 ) level was ≤20 ng/mL , 0.1 mg/kg b.d . if the C ( 2 ) level was 21-59 ng/mL or 0.05 mg/kg b.d . if the C ( 2 ) 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 C ( 2 ) 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 C ( 2 ) does lead to patients achieving a whole-blood concentration of ≥10 ng/mL sooner .
48046
Intervention_Pharmacological
tacrolimus
48047
Outcome_Physical
tacrolimus requirements post-transplant
48048
Outcome_Physical
tacrolimus whole-blood concentrations
48049
Participant_Condition
post-transplant
48050
Participant_Condition
kidney transplantation