Corpus ID: 77699449

Strategies to optimize tacrolimus treatment and improve long-term clinical outcomes in solid organ transplantation

  title={Strategies to optimize tacrolimus treatment and improve long-term clinical outcomes in solid organ transplantation},
  author={N. Shuker},
markdownabstractAlthough tacrolimus has been in widespread use since the 1990s, there are still a number of unanswered questions related to its clinical use. For example, the optimal starting dose of tacrolimus and the optimal target concentration in both the early and late phase after transplantation, are unknown. At present, the main challenge to transplant physicians is to improve the long-term outcomes of solid organ transplantation while maintaining the good short-term outcomes that have… Expand


Opportunities to Optimize Tacrolimus Therapy in Solid Organ Transplantation: Report of the European Consensus Conference
The importance of obtaining multicenter prospective trials to assess the efficacy of alternative strategies to TAC trough concentrations is emphasized, and single time points, limited sampling strategies, and area under concentration-time curve have all been considered to determine the most appropriate sampling procedure that correlates with efficacy. Expand
Tacrolimus: a further update of its pharmacology and therapeutic use in the management of organ transplantation.
Tacrolimus is an important therapeutic option for the optimal individualisation of immunosuppressive therapy in transplant recipients and may well be an influential factor in selecting the optimal treatment for patients undergoing organ transplantation. Expand
The Role of Pharmacogenetics in the Disposition of and Response to Tacrolimus in Solid Organ Transplantation
A randomised controlled study in kidney transplant recipients has demonstrated that a CYP3A5 genotype-based approach to tacrolimus dosing leads to more patients reaching the target concentration early after transplantation, but no improvement of clinical outcomes was observed, which may have been the result of the design of this particular study. Expand
Optimization of Initial Tacrolimus Dose Using Pharmacogenetic Testing
Pharmacogenetic adaptation of the daily dose of tacrolimus is associated with improved achievement of the target C0, and whether this improvement will affect clinical outcomes requires further evaluation. Expand
Trough Tacrolimus Concentrations in the First Week After Kidney Transplantation Are Related to Acute Rejection
The results confirm that tacrolimus trough concentrations during the first week are an important predictor of acute rejection and it is critical to reach target blood concentrations of tacolimus as soon as possible to improve allograft survival. Expand
Organ transplantation: historical perspective and current practice.
The results of organ transplantation continue to improve, both as a consequence of the above innovations and the improvements in peri- and postoperative management. Expand
Clinical implementation of pharmacogenetics in kidney transplantation: calcineurin inhibitors in the starting blocks.
The purpose of the present review is to picture the current status of CNI pharmacogenetics and to discuss the most promising leads that have been followed so far. Expand
Comparison of Low Versus High Tacrolimus Levels in Kidney Transplantation: Assessment of Efficacy by Protocol Biopsies
Modest reductions in tacrolimus exposure early posttransplant are associated with significant beneficial effects for the patient and the allograft without an increased immunologic risk. Expand
Clinical Efficacy and Toxicity Profile of Tacrolimus and Mycophenolic Acid in Relation to Combined Long‐term Pharmacokinetics in de Novo Renal Allograft Recipients
Clinicians need reliable drug monitoring tools for relating efficacy and toxicity to drug exposure in renal transplant recipients. Expand
Lack of Improvement in Renal Allograft Survival Despite a Marked Decrease in Acute Rejection Rates Over the Most Recent Era
This work analyzed data provided by the Scientific Registry of Transplant Recipients regarding all adult first renal transplants between 1995 and 2000 to investigate how acute rejection rates have evolved on a national level in the U.S and how this has impacted graft survival in the most recent era of kidney transplantation. Expand