Trial reportClinical pharmacokinetics2020
Unbound Plasma, Total Plasma, and Whole-Blood Tacrolimus Pharmacokinetics Early After Thoracic Organ Transplantation.
Trial report in Clinical pharmacokinetics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Model-Informed Precision Dosing of Tacrolimus: A Systematic Review of Population Pharmacokinetic Models and a Benchmark Study of Software Tools.Clinical pharmacokinetics · 2024Pooled it
- Population Pharmacokinetic Models of Tacrolimus in Adult Transplant Recipients: A Systematic Review.Clinical pharmacokinetics · 2020Pooled it
- A Point-of-Care Test to Measure Tacrolimus Directly from Unprocessed Whole Blood.Analytical chemistry · 2026Article
- Comparing Whole-Blood and Plasma Tacrolimus Intra-Patient Variability for Predicting Allograft Rejection in Kidney Transplantation.Clinical and translational science · 2026Article
- Hematocrit-adjusted tacrolimus levels are associated with acute kidney injury but not rejection early after liver transplantation.Frontiers in transplantation · 2026Article
- Discordance between trough concentration and tacrolimus exposure on the day of kidney transplantation: a prospective pharmacokinetic study.Frontiers in pharmacology · 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
- Concentration-dependent blood binding: assessing implications through physiologically based Pharmacokinetic modeling of tacrolimus as a case example.Journal of pharmacokinetics and pharmacodynamics · 2025Article
- Approach to the prevention of atypical hemolytic uremic syndrome recurrence using eculizumab in a pregnant kidney transplant recipient with complement factor H gene mutation: a case report and literature review.Journal of nephrology · 2025Review
- Plasma Versus Whole Blood Tacrolimus Concentrations and Health-Related Quality of Life in Kidney Transplant Recipients.Pharmaceutics · 2025Article
- Tacrolimus Dose Requirement inTransplant international : official journal of the European Society for Organ Transplantation · 2024Article
- Article
- A Joint Pharmacokinetic Model for the Simultaneous Description of Plasma and Whole Blood Tacrolimus Concentrations in Kidney and Lung Transplant Recipients.Clinical pharmacokinetics · 2023Article
- Importance of Pharmacogenetics and Drug-Drug Interactions in a Kidney Transplanted Patient.Life (Basel, Switzerland) · 2023Article
- Tacrolimus-why pharmacokinetics matter in the clinic.Frontiers in transplantation · 2023Review
- Article
- Variability of Tacrolimus Trough Concentration in Liver Transplant Patients: Which Role of Inflammation?Pharmaceutics · 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
- Erratum issued
Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveTherapeutic drug monitoring of tacrolimus whole-blood concentrations is standard care in thoracic organ transplantation. Nevertheless, toxicity may appear with alleged therapeutic concentrations possibly related to variability in unbound concentrations. However, pharmacokinetic data on unbound concentrations are not available. The objective of this study was to quantify the pharmacokinetics of whole-blood, total, and unbound plasma tacrolimus in patients early after heart and lung transplantation.
methodsTwelve-hour tacrolimus whole-blood, total, and unbound plasma concentrations of 30 thoracic organ recipients were analyzed with high-performance liquid chromatography-tandem mass spectrometry directly after transplantation. Pharmacokinetic modeling was performed using non-linear mixed-effects modeling.
resultsPlasma concentration was < 1% of the whole-blood concentration. Maximum binding capacity of erythrocytes was directly proportional to hematocrit and estimated at 2700 pg/mL (95% confidence interval 1750-3835) with a dissociation constant of 0.142 pg/mL (95% confidence interval 0.087-0.195). The inter-individual variability in the binding constants was considerable (27% maximum binding capacity, and 29% for the linear binding constant of plasma).
conclusionsTacrolimus association with erythrocytes was high and suggested a non-linear distribution at high concentrations. Monitoring hematocrit-corrected whole-blood tacrolimus concentrations might improve clinical outcomes in clinically unstable thoracic organ transplants. CLINICAL
trial registrationNTR 3912/EudraCT 2012-001909-24.
Indexed as
Identifiers
What OpenQuestion holds
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.