ArticleTransplant international : official journal of the European Society for Organ Transplantation2023
The Tacrolimus Concentration/Dose Ratio Does Not Predict Early Complications After Kidney Transplantation.
Article in Transplant international : official journal of the European Society for Organ Transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Low Tacrolimus CClinical pharmacokinetics · 2026Article
- Tacrolimus Concentration/Dose Ratio in Hematopoietic Cell Transplantation Recipients: An Exploratory Study of Metabolizer Phenotyping and Clinical Outcomes.Clinical and translational science · 2026Article
- Association of intrapatient tacrolimus variability and concentration-to-dose ratio with outcomes in pediatric kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2025Article
- Ethnic differences in early blood tacrolimus concentrations after kidney transplantation: a retrospective observational study.BMC nephrology · 2025Observational
- The tacrolimus concentration-to-dose ratio is associated with kidney function in heart transplant recipients.British journal of clinical pharmacology · 2025Article
- Optimization of the Tacrolimus Concentration-to-Dose Ratio Cut-Off Value to Define Metabolism Groups.Journal of clinical medicine · 2025Article
- Evaluation of efficacy and safety of generic tacrolimus (SuprotacEuropean journal of translational myology · 2025Article
- Renal Allograft Function and the Tacrolimus C/D Ratio: Insights from a Prospective Study on MeltDose Tacrolimus.Journal of clinical medicine · 2024Article
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13 authors.
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Abstract
Early-on post kidney transplantation, there is a high risk of graft rejection and opportunistic viral infections. A low tacrolimus concentration/dose (C/D) ratio as a surrogate marker of fast tacrolimus metabolism has been established for risk stratification 3 months post-transplantation (M3). However, many adverse events occurring earlier might be missed, and stratification at 1 month post-transplantation (M1) has not been investigated. We retrospectively analyzed case data from 589 patients who had undergone kidney transplantation between 2011 and 2021 at three German transplant centers. Tacrolimus metabolism was estimated by use of the C/D ratio at M1, M3, M6, and M12. C/D ratios increased substantially during the year, particularly between M1 and M3. Many viral infections and most graft rejections occurred before M3. Neither at M1 nor at M3 was a low C/D ratio associated with susceptibility to BKV viremia or BKV nephritis. A low C/D ratio at M1 could not predict acute graft rejections or impaired kidney function, whereas at M3 it was significantly associated with subsequent rejections and impairment of kidney function. In summary, most rejections occur before M3, but a low C/D ratio at M1 does not identify patients at risk, limiting the predictive utility of this stratification approach.
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