TY  - JOUR
AU  - Daldoul, Mouna
AU  - Charfi, Rim
AU  - Ferchichi, Khouloud
AU  - Sassi, Mouna Ben
AU  - Hammamia, Syrine Ben
AU  - Medhioub, Fatma
AU  - Gaies, Emna
AU  - Enneifer, Rym
AU  - Eljebari, Hanene
AU  - Klouz, Anis
AU  - Daghfous, Riadh
AU  - Trabelsi, Sameh
PY  - 2024
DA  - 2024/12/13
TI  - Tacrolimus Therapeutic Response, Pharmacokinetics and Adherence in Liver Transplant Recipients
JO  - OBM Transplantation
SP  - 228
VL  - 08
IS  - 04
AB  - Background:
Tacrolimus is characterized by a high intra and interindividual pharmacokinetics variability. Data regarding factors that may influence its pharmacokinetics and pharmacodynamics in liver transplantation are limited.
The objectives of this study were to assess tacrolimus therapeutic response, pharmacokinetics and adherence in liver transplant recipients.
Methods:
The study was conducted at the Clinical Pharmacology Department over a period of 12 years from January 2009 to March 2021. We included liver transplant patients treated with tacrolimus referred to our department for tacrolimus therapeutic drug monitoring. Secondly, we assessed tacrolimus adherence in liver transplant recipients by using a prospective Morisky questionnaire.
Results:
We included 894 tacrolimus trough concentration C0 from 76 patients. The mean age was 24.4 ± 10.2 years. The sex-ratio M/F was 1.3. The median C0 was 8.53 ± 4.7 ng/mL. In 48.2% of cases, the C0 was in the therapeutic range. Children required higher weight doses of tacrolimus compared to adults. C0 and C0/dose ratio of tacrolimus were higher in adults and in male patients. Bilirubinemia, polypharmacy, and adherence were weakly correlated with C0. Mycophenolate mofetil, prednisolone, mehylprednisolone, amphotericin B, fluconazole, and omeprazole were associated with increased tacrolimus C0 while irbesartan was associated with decreased tacrolimus C0. The intraindividual coefficient of variability (CV) ranged from 20.4 to 119%. The interindividual CV was 46.1%. The tacrolimus index of variability ranged from 1.6 to 15.1. Age greater than 18 years increased tacrolimus adherence by 3.892-fold in liver transplant patients.
Conclusions: Tacrolimus bioavailability was higher in adults and in men. Adherence increased by 3.892-fold in liver transplant adults.
SN  - 2577-5820
UR  - https://doi.org/10.21926/obm.transplant.2404228
DO  - 10.21926/obm.transplant.2404228
ID  - Daldoul2024
ER  -