The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas
Tacrolimus, the keystone immunosuppressive drug administered after solid organ transplantation, presents a narrow therapeutic index and wide inter- and intra-patient pharmacokinetic variability (IPV). The latter has been fairly studied in kidney transplantation, where it could impact outcomes. Howev...
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MDPI AG
2022-02-01
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Series: | Pharmaceutics |
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Online Access: | https://www.mdpi.com/1999-4923/14/2/379 |
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author | Gwendal Coste Florian Lemaitre |
author_facet | Gwendal Coste Florian Lemaitre |
author_sort | Gwendal Coste |
collection | DOAJ |
description | Tacrolimus, the keystone immunosuppressive drug administered after solid organ transplantation, presents a narrow therapeutic index and wide inter- and intra-patient pharmacokinetic variability (IPV). The latter has been fairly studied in kidney transplantation, where it could impact outcomes. However, literature about other transplanted organ recipients remains inconclusive. This review aimed at summarizing the evidence about the IPV of tacrolimus concentrations outside of the scope of kidney transplantation. First, factors influencing IPV will be presented. Then, the potential of IPV as a biomarker predictive of graft outcomes will be discussed in liver, heart, lung and pancreas transplantation. Lastly, strategies to reduce IPV will be reviewed, with the ultimate objective being ready-to-implement solutions in clinical practice by transplantation professionals. |
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id | doaj.art-cdd764c67c85435685c17c2a6386b5b2 |
institution | Directory Open Access Journal |
issn | 1999-4923 |
language | English |
last_indexed | 2024-03-09T21:14:21Z |
publishDate | 2022-02-01 |
publisher | MDPI AG |
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series | Pharmaceutics |
spelling | doaj.art-cdd764c67c85435685c17c2a6386b5b22023-11-23T21:38:22ZengMDPI AGPharmaceutics1999-49232022-02-0114237910.3390/pharmaceutics14020379The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and PancreasGwendal Coste0Florian Lemaitre1Irset (Institut de Recherche en Santé, Environnement et Travail)—UMR S 1085, EHESP, Inserm, CHU Rennes, Université Rennes 1, F-35000 Rennes, FranceIrset (Institut de Recherche en Santé, Environnement et Travail)—UMR S 1085, EHESP, Inserm, CHU Rennes, Université Rennes 1, F-35000 Rennes, FranceTacrolimus, the keystone immunosuppressive drug administered after solid organ transplantation, presents a narrow therapeutic index and wide inter- and intra-patient pharmacokinetic variability (IPV). The latter has been fairly studied in kidney transplantation, where it could impact outcomes. However, literature about other transplanted organ recipients remains inconclusive. This review aimed at summarizing the evidence about the IPV of tacrolimus concentrations outside of the scope of kidney transplantation. First, factors influencing IPV will be presented. Then, the potential of IPV as a biomarker predictive of graft outcomes will be discussed in liver, heart, lung and pancreas transplantation. Lastly, strategies to reduce IPV will be reviewed, with the ultimate objective being ready-to-implement solutions in clinical practice by transplantation professionals.https://www.mdpi.com/1999-4923/14/2/379intra-patient variabilitydrugmonitoringpharmacokineticstacrolimusliver transplantation |
spellingShingle | Gwendal Coste Florian Lemaitre The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas Pharmaceutics intra-patient variability drug monitoring pharmacokinetics tacrolimus liver transplantation |
title | The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas |
title_full | The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas |
title_fullStr | The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas |
title_full_unstemmed | The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas |
title_short | The Role of Intra-Patient Variability of Tacrolimus Drug Concentrations in Solid Organ Transplantation: A Focus on Liver, Heart, Lung and Pancreas |
title_sort | role of intra patient variability of tacrolimus drug concentrations in solid organ transplantation a focus on liver heart lung and pancreas |
topic | intra-patient variability drug monitoring pharmacokinetics tacrolimus liver transplantation |
url | https://www.mdpi.com/1999-4923/14/2/379 |
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