Bibliographic Details
| Title: |
Therapeutic Drug Monitoring of Tacrolimus-Personalized Therapy in Heart Transplantation: New Strategies and Preliminary Results in Endomyocardial Biopsies |
| Authors: |
Simona De Gregori, Annalisa De Silvestri, Barbara Cattadori, Andrea Rapagnani, Riccardo Albertini, Elisa Novello, Monica Concardi, Eloisa Arbustini, Carlo Pellegrini |
| Source: |
Pharmaceutics, Vol 14, Iss 6, p 1247 (2022) |
| Publisher Information: |
MDPI AG, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Pharmacy and materia medica |
| Subject Terms: |
heart transplantation, acute rejection, therapeutic drug monitoring, tacrolimus, endomyocardial biopsies, Pharmacy and materia medica, RS1-441 |
| More Details: |
Tacrolimus (TAC) is an immunosuppressant drug approved both in the US and in the EU, widely used for the prophylaxis of organ rejection after transplantation. This is a critical dose drug: low levels in whole blood can lead to low exposure and a high risk of acute rejection, whereas overexposure puts patients at risk for toxicity and infection. Both situations can occur at whole-blood concentrations considered to be within the narrow TAC therapeutic range. We assumed a poor correlation between TAC trough concentrations in whole blood and the incidence of acute rejection; therefore, we propose to study TAC concentrations in endomyocardial biopsies (EMBs). We analyzed 70 EMBs from 18 transplant recipients at five scheduled follow-up visits during the first year post-transplant when closer TAC monitoring is mandatory. We observed five episodes of acute rejection (grade 2R) in three patients (2 episodes at 0.5 months, 2 at 3 months, and 1 at 12 months), when TAC concentrations in EMBs were low (63; 62; 59; 31; 44 pg/mg, respectively), whereas concentrations in whole blood were correct. Our results are preliminary and further studies are needed to confirm the importance of this new strategy to prevent acute rejection episodes. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1999-4923 |
| Relation: |
https://www.mdpi.com/1999-4923/14/6/1247; https://doaj.org/toc/1999-4923 |
| DOI: |
10.3390/pharmaceutics14061247 |
| Access URL: |
https://doaj.org/article/d4899cab7dde4d5cb8e91864ca978293 |
| Accession Number: |
edsdoj.4899cab7dde4d5cb8e91864ca978293 |
| Database: |
Directory of Open Access Journals |
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