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Evaluation of tacrolimus abbreviated area‐under‐the‐curve monitoring in renal transplant patients who are potientially at risk for adverse events
Author(s) -
Hon Yuen Yi,
Chamberlain Christine E.,
Kleiner David E.,
Ring Michael S.,
Hale Douglas A.,
Kirk Allan D.,
Man Roslyn B.
Publication year - 2010
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01143.x
Subject(s) - medicine , tacrolimus , adverse effect , area under the curve , biopsy , gastroenterology , cohort , urology , renal transplant , trough level , transplantation
Hon YY, Chamberlain CE, Kleiner DE, Ring MS, Hale DA, Kirk AD, Mannon RB. Evaluation of tacrolimus abbreviated area‐under‐the‐curve monitoring in renal transplant patients who are potientially at risk for adverse events.
Clin Transplant 2010: 24: 557–563.
© 2009 John Wiley & Sons A/S. Abstract: In a cohort of 32 renal transplant patients who are potentially at risk for adverse events, we compared tacrolimus (TAC) abbreviated AUC values calculated by a method developed in Asians (AUCw) with those derived for Caucasians (AUCa). The relationships between TAC trough (C0), abbreviated AUC, and biopsy results were also assessed. Forty‐eight AUCs and 15 associated biopsies were evaluated. For AUCs obtained only from Caucasian patients, median AUCw value was lower than that of AUCa (104 vs. 115 ng × h/mL, n = 29, p < 0.0001). AUCs obtained from the two methods for all patients correlated with C0 ( r s > 0.72, n = 48, p < 0.0001). Median AUCw (72.9 vs. 174 ng × h/mL, p = 0.043) and AUCa (81.0 vs. 203 ng × h/mL, p = 0.043) were lower in patients experiencing biopsy‐proven acute rejection (AR) than those with normal histology. C0 tended to be lower in biopsies showing AR >6 months post‐transplant (5.80 vs. 11.0 ng/mL, p = 0.110). Thus, lower abbreviated AUCs were obtained for Caucasians using a method developed in Asians. C0 correlated well with abbreviated AUCs. Lower C0 and AUC appeared to be associated with biopsy‐proven AR > 6 months post‐transplant. Further prospective evaluation of TAC AUC and C0 monitoring in a larger cohort of patients is warranted.