Optimization of tacrolimus therapy in kidney transplantation

Abstract

Tacrolimus (TAC), the most frequently used component
of the immunosuppression regimen after kidney
transplantation, is characterized by high pharmacokinetic
and pharmacodynamic inter- as well
as intra-patient variability. Its metabolism is affected
by numerous genetic and clinical factors which requires
adoption of individualized regimen. Simple
practical strategies are therefore clearly needed to
identify patients at risk of poor outcome who would
benefit from a more personalized approach for TAC
treatment. The different factors such as intra-patient
variability of TAC, rate of metabolism, age, immunological
risk, comorbidity, behavioral habits etc.
should be taken into account in optimization and
personalization of TAC therapy. This review shows
the link between the pharmacokinetics of tacrolimus
and the clinical needs of solid organ recipients.