Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Sep 18;13(5):254-263.
doi: 10.5500/wjt.v13.i5.254.

Impact of tacrolimus intra-patient variability in adverse outcomes after organ transplantation

Maria Clara Morais  1 , Maria Eduarda Soares  2 , Gabriela Costa  1 , Laura Guerra  1 , Nayana Vaz  1   3 , Liana Codes  1   3 , Paulo Lisboa Bittencourt  1   4
Affiliations
Review

Impact of tacrolimus intra-patient variability in adverse outcomes after organ transplantation

Maria Clara Morais et al. World J Transplant. .

Abstract

Tacrolimus (Tac) is currently the most common calcineurin-inhibitor employed in solid organ transplantation. High intra-patient variability (IPV) of Tac (Tac IPV) has been associated with an increased risk of immune-mediated rejection and poor outcomes after kidney transplantation. Few data are available concerning the impact of high Tac IPV in non-kidney transplants. However, even in kidney transplantation, there is still a controversy whether high Tac IPV is indeed detrimental in respect to graft and/or patient survival. This may be due to different methods employed to evaluate IPV and distinct time frames adopted to assess graft and patient survival in those reports published up to now in the literature. Little is also known about the influence of high Tac IPV in the development of other untoward adverse events, update of the current knowledge regarding the impact of Tac IPV in different outcomes following kidney, liver, heart, lung, and pancreas tran splantation to better evaluate its use in clinical practice.

Keywords: Graft survival; Intra-patient variability; Organ transplantation; Outcomes; Rejection; Tacrolimus.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: Authors declare no conflict of interests for this article.

References

    1. Ong SC, Gaston RS. Thirty Years of Tacrolimus in Clinical Practice. Transplantation . 2021;105:484–495. - PubMed
    1. Staatz CE, Tett SE. Clinical pharmacokinetics and pharmacodynamics of tacrolimus in solid organ transplantation. Clin Pharmacokinet . 2004;43:623–653. - PubMed
    1. Shuker N, van Gelder T, Hesselink DA. Intra-patient variability in tacrolimus exposure: causes, consequences for clinical management. Transplant Rev (Orlando) . 2015;29:78–84. - PubMed
    1. Brunet M, Pastor-Anglada M. Insights into the Pharmacogenetics of Tacrolimus Pharmacokinetics and Pharmacodynamics. Pharmaceutics . 2022;14 - PMC - PubMed
    1. Kuypers DRJ. Intrapatient Variability of Tacrolimus Exposure in Solid Organ Transplantation: A Novel Marker for Clinical Outcome. Clin Pharmacol Ther . 2020;107:347–358. - PubMed