Tacrolimus intrapatient variability in solid organ transplantation: A multiorgan perspective.

摘要: Background Tacrolimus therapy in solid organ transplant (SOT) recipients is challenging due to its narrow therapeutic window and pharmacokinetic variability both between patients within a single patient. Intrapatient (IPV) of tacrolimus trough concentrations has become novel marker interest for predicting outcomes. The purpose this review evaluate the association IPV with graft patient outcomes identify interventions improve SOT recipients. Methods A systematic literature was performed using PubMed Embase from database inception September 20, 2020. Studies were eligible only if they evaluated an Both pediatric adult studies included. Measures limited standard deviation, coefficient variation, time range. Results Forty-four met inclusion criteria. published 2008 2020 observational nature. Majority data kidney identified rejection, de novo donor specific antibody (dnDSA) formation, loss, survival. Evaluation IPV-directed small preliminary studies. Conclusions High been associated poor including acute dnDSA mortality Future research should prospectively explore