A comprehensive review of the impact of tacrolimus intrapatient variability on clinical outcomes in kidney transplantation.
graft survival
health services and outcomes research
immunosuppressant - calcineurin inhibitor: tacrolimus
kidney transplantation/nephrology
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
18
12
2019
revised:
19
04
2020
accepted:
19
04
2020
pubmed:
15
5
2020
medline:
22
6
2021
entrez:
15
5
2020
Statut:
ppublish
Résumé
Tacrolimus (Tac) is widely used to prevent rejection and graft loss in solid organ transplantation. A limiting characteristic of Tac is the high intra and interpatient variability associated with its use. Routine therapeutic drug monitoring (TDM) is necessary to facilitate Tac management and to avoid undesirable clinical outcomes. However, whole blood trough concentrations commonly utilized in TDM are not strong predictors of the detrimental clinical outcomes of interest. Recently, researchers have focused on Tac intrapatient variability (Tac IPV) as a novel marker to better assess patient risk. Higher Tac IPV has been associated with a number of mechanisms leading to shortened graft survival. Medication nonadherence (MNA) is considered to be the primary determinant of high Tac IPV and perhaps the most modifiable risk factor. An understanding of the methodology behind Tac IPV is imperative to its recognition as an important prognostic measure and integration into clinical practice. Therapeutic interventions targeting MNA and reducing Tac IPV are crucial to improving long-term graft survival.
Identifiants
pubmed: 32406604
doi: 10.1111/ajt.16002
pii: S1600-6135(22)22502-7
doi:
Substances chimiques
Immunosuppressive Agents
0
Tacrolimus
WM0HAQ4WNM
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1969-1983Informations de copyright
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
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