Observational studyEuropean journal of drug metabolism and pharmacokinetics2018
Association of Whole Blood Tacrolimus Concentrations with Kidney Injury in Heart Transplantation Patients.
Observational study in European journal of drug metabolism and pharmacokinetics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Unbound Plasma, Total Plasma, and Whole-Blood Tacrolimus Pharmacokinetics Early After Thoracic Organ Transplantation.Clinical pharmacokinetics · 2020Trial
- Impact of Azole Antifungals on the Conversion Ratio of Immediate-release Tacrolimus to LCP-Tacrolimus Tablets in Non-kidney Solid Organ Transplant Recipients.Transplantation direct · 2026Article
- Supratherapeutic drug concentration triggers: A novel data-driven approach to assess their value for medication safety surveillance in intensive care.British journal of clinical pharmacology · 2026Article
- Kidney allograft outcomes in combined kidney with other solid organ transplantation.World journal of transplantation · 2026Review
- Case Report: Kidney allograft recovery after conversion to belatacept-based immunosuppression in simultaneous heart-kidney transplantation.Frontiers in immunology · 2026Article
- A genotype-guided prediction model for the incidence of persistent acute kidney injury following lung transplantation.BMC nephrology · 2024Article
- Steroid-tacrolimus drug-drug interaction and the effect of CYP3A genotypes.British journal of clinical pharmacology · 2024Article
- Severe Acute Kidney Injury Postheart Transplantation: Analysis of Risk Factors.Transplantation direct · 2024Article
- Tacrolimus and Cyclosporin Pharmacotherapy, Detection Methods, Cytochrome P450 Enzymes after Heart Transplantation.Cardiovascular & hematological agents in medicinal chemistry · 2024Review
- Case report and literature review: management of Paxlovid (nirmatrelvir/ritonavir)-induced acute tacrolimus toxicity in a patient with systemic lupus erythematosus.Frontiers in pharmacology · 2024Article
- Machine learning to predict post-operative acute kidney injury stage 3 after heart transplantation.BMC cardiovascular disorders · 2022Article
- The impact of cytochrome P450 3A5 genotype on early tacrolimus metabolism and clinical outcomes in lung transplant recipients.International journal of clinical pharmacy · 2022Article
- Risk Factors for Acute Kidney Injury Requiring Renal Replacement Therapy after Orthotopic Heart Transplantation in Patients with Preserved Renal Function.Journal of clinical medicine · 2021Article
- Need for improvements in simultaneous heart-kidney allocation: The limitation of pretransplant glomerular filtration rate.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- High Variability of Whole-Blood Tacrolimus Pharmacokinetics Early After Thoracic Organ Transplantation.European journal of drug metabolism and pharmacokinetics · 2020Article
- Influence of Germline Genetics on Tacrolimus Pharmacokinetics and Pharmacodynamics in Allogeneic Hematopoietic Stem Cell Transplant Patients.International journal of molecular sciences · 2020Article
- Acute Kidney Injury in Patients Undergoing Cardiac Transplantation: A Meta-Analysis.Medicines (Basel, Switzerland) · 2019Article
- Acute kidney injury in patients undergoing cardiac transplantation: a cohort study on incidence and risk factors in the first three years of service implementation.Jornal brasileiro de nefrologiaArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAcute kidney injury (AKI) is frequently observed after heart transplantation and is associated with morbidity and mortality. However, many confounding factors also contribute to the development of AKI in heart transplants. We hypothesized that supratherapeutic whole-blood tacrolimus trough concentrations are associated with AKI.
methodsIn a retrospective observational cohort from April 2005 to December 2012, all adult heart transplantation patients were included. AKI was assessed in the first 2 weeks after transplantation as classified by the Kidney Disease Improving Global Outcomes Network (KDIGO). Whole-blood tacrolimus trough concentrations were determined from day 1 to day 14 and at 1, 3, 6 and 12 months post-transplantation. The therapeutic range was 9 to 15 ng/ml in the first 2 months and tapered to 5-8 ng/ml thereafter. The relationship between supratherapeutic tacrolimus trough concentrations and AKI was evaluated. The impact of various potentially confounding factors on tacrolimus concentrations and AKI was considered.
resultsWe included 110 patients. AKI occurred in 57% of patients in the first week. Recovery from AKI was seen in 24%. The occurrence of chronic kidney disease (CKD) was 19% at 1 year. Whole-blood tacrolimus trough concentrations were often supratherapeutic and, despite correction for confounding factors, independently associated with AKI (OR 1.66; 95% CI 1.20-2.31).
conclusionsSupratherapeutic whole-blood tacrolimus trough concentrations are independently associated with the development of AKI in adult heart transplantation patients. More stringent dosing of tacrolimus early after transplantation may be critical in preserving the kidney function.
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