ArticleJournal of clinical medicine2020
Conversion to Everolimus was Beneficial and Safe for Fast and Slow Tacrolimus Metabolizers After Renal Transplantation.
Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- The tacrolimus concentration-to-dose ratio is associated with kidney function in heart transplant recipients.British journal of clinical pharmacology · 2025Article
- Early Determination of Tacrolimus Concentration-Dose Ratio Identifies Risk of Allograft Loss in Kidney Transplantation.Kidney international reports · 2025Article
- Pharmacodynamic effect of mTOR inhibition-based immunosuppressive therapy on dendritic cell and natural killer cell subsets after renal transplantation.Clinical and experimental immunology · 2025Article
- Pharmacodynamic Effect of mTOR Inhibition-based Immunosuppressive Therapy on T- and B-cell Subsets After Renal Transplantation.Transplantation direct · 2024Article
- Tacrolimus-why pharmacokinetics matter in the clinic.Frontiers in transplantation · 2023Review
- Increased renal function decline in fast metabolizers using extended-release tacrolimus after kidney transplantation.Scientific reports · 2021Article
- Commentary: The Clinical Impact of the CFrontiers in pharmacology · 2021Article
- Impacts of High Intra- and Inter-Individual Variability in Tacrolimus Pharmacokinetics and Fast Tacrolimus Metabolism on Outcomes of Solid Organ Transplant Recipients.Journal of clinical medicine · 2020Article
- Promises of Big Data and Artificial Intelligence in Nephrology and Transplantation.Journal of clinical medicine · 2020Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fast tacrolimus (TAC) metabolism (concentration/dose (C/D) ratio < 1.05 ng/ml/mg) is a risk factor for inferior outcomes after renal transplantation (RTx) as it fosters, e.g., TAC-related nephrotoxicity. TAC minimization or conversion to calcineurin-inhibitor free immunosuppression are strategies to improve graft function. Hence, we hypothesized that especially patients with a low C/D ratio profit from a switch to everolimus (EVR). We analyzed data of 34 RTx recipients (17 patients with a C/D ratio < 1.05 ng/ml/mg vs. 17 patients with a C/D ratio ≥ 1.05 ng/ml/mg) who were converted to EVR within 24 months after RTx. The initial immunosuppression consisted of TAC, mycophenolate, prednisolone, and basiliximab induction. During an observation time of 36 months after changing immunosuppression from TAC to EVR, renal function, laboratory values, and adverse effects were compared between the groups. Fast TAC metabolizers were switched to EVR 4.6 (1.5-21.9) months and slow metabolizers 3.3 (1.8-23.0) months after RTx (p = 0.838). Estimated glomerular filtration rate (eGFR) did not differ between the groups at the time of conversion (baseline). Thereafter, the eGFR in all patients increased noticeably (fast metabolizers eGFR 36 months: + 11.0 ± 11.7 (p = 0.005); and slow metabolizers eGFR 36 months: + 9.4 ± 15.9 mL/min/1.73m² (
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