ArticleClinical pharmacokinetics2020
Clinical Pharmacokinetics and Impact of Hematocrit on Monitoring and Dosing of Tacrolimus Early After Heart and Lung Transplantation.
Article in Clinical pharmacokinetics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 28 citations in OpenAlex.
- Precision Dosing of Tacrolimus in Liver Transplantation: Integrating Donor-Recipient CYP3A5 Pharmacogenomics and Drug Interactions.CPT: pharmacometrics & systems pharmacology · 2026Article
- A Point-of-Care Test to Measure Tacrolimus Directly from Unprocessed Whole Blood.Analytical chemistry · 2026Article
- Calcineurin inhibitor monitoring in allogeneic hematopoietic cell transplantation: time to move beyond solid organ transplant paradigms.Frontiers in immunology · 2026Review
- Hematocrit-adjusted tacrolimus levels are associated with acute kidney injury but not rejection early after liver transplantation.Frontiers in transplantation · 2026Article
- Population pharmacokinetic characteristics of tacrolimus in Chinese lung transplant recipients and optimisation of dosing regimen during the early post-transplantation phase.European journal of clinical pharmacology · 2025Article
- Tacrolimus exposure during the three-month period following allogeneic stem cell transplantation predicts overall survival.Frontiers in pharmacology · 2025Article
- Tacrolimus Variability and Clinical Outcomes in the Early Post-lung Transplantation Period: Oral Versus Continuous Intravenous Administration.Clinical pharmacokinetics · 2024Article
- Effects ofPharmaceuticals (Basel, Switzerland) · 2024Article
- Emerging therapeutic drug monitoring technologies: considerations and opportunities in precision medicine.Frontiers in pharmacology · 2024Review
- A Physiologically Based Pharmacokinetic Approach to Recommend an Individual Dose of Tacrolimus in Adult Heart Transplant Recipients.Pharmaceutics · 2023Article
- The impact of cytochrome P450 3A5 genotype on early tacrolimus metabolism and clinical outcomes in lung transplant recipients.International journal of clinical pharmacy · 2022Article
- Variability of Tacrolimus Trough Concentration in Liver Transplant Patients: Which Role of Inflammation?Pharmaceutics · 2021Article
- Factors Affecting Time-Varying Clearance of Cyclosporine in Adult Renal Transplant Recipients: A Population Pharmacokinetic Perspective.Pharmaceutical research · 2021Article
- Functional CYP3A variants affecting tacrolimus trough blood concentrations in Chinese renal transplant recipients.The pharmacogenomics journal · 2021Article
- Model-Informed Precision Dosing of Everolimus: External Validation in Adult Renal Transplant Recipients.Clinical pharmacokinetics · 2021Article
- Case Report: Low Hematocrit Leading to Tacrolimus Toxicity.Frontiers in pharmacology · 2021Article
- Population Pharmacokinetic Analysis of Tacrolimus in Adult Chinese Patients with Myasthenia Gravis: A Prospective Study.European journal of drug metabolism and pharmacokinetics · 2020Observational
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The calcineurin inhibitor tacrolimus is an effective immunosuppressant and is extensively used in solid organ transplantation. In the first week after heart and lung transplantation, tacrolimus dosing is difficult due to considerable physiological changes because of clinical instability, and toxicity often occurs, even when tacrolimus concentrations are within the therapeutic range. The physiological and pharmacokinetic changes are outlined. Excessive variability in bioavailability may lead to higher interoccasion (dose-to-dose) variability than interindividual variability of pharmacokinetic parameters. Intravenous tacrolimus dosing may circumvent this high variability in bioavailability. Moreover, the interpretation of whole-blood concentrations is discussed. The unbound concentration is related to hematocrit, and changes in hematocrit may increase toxicity, even within the therapeutic range of whole-blood concentrations. Therefore, in clinically unstable patients with varying hematocrit, aiming at the lower therapeutic level is recommended and tacrolimus personalized dosing based on hematocrit-corrected whole-blood concentrations may be used to control the unbound tacrolimus plasma concentrations and subsequently reduce toxicity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.