4CPS-042 Pharmacokinetic monitoring of tacrolimus in renal transplant patients

Background and importanceTacrolimus (TAC), a calcineurin inhibitor, is indicated in renal transplantation, and its monitoring is important due to its pharmacokinetic variability.Aim and objectivesTo describe the demographic, clinical and pharmacokinetic characteristics of patients in immediate post-...

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Published in:European journal of hospital pharmacy. Science and practice 2022-03, Vol.29 (Suppl 1), p.A41-A42
Main Authors: Guillen Martinez, O, Gutierrez Palomo, S, Rodriguez Morote, M, Soriano Irigaray, L, Garcia Monsalve, A, Navarro Ruiz, A
Format: Article
Language:English
Subjects:
Body mass index
Conflicts of interest
Kidney transplants
Pharmacokinetics
Section 4: Clinical pharmacy services
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Summary:Background and importanceTacrolimus (TAC), a calcineurin inhibitor, is indicated in renal transplantation, and its monitoring is important due to its pharmacokinetic variability.Aim and objectivesTo describe the demographic, clinical and pharmacokinetic characteristics of patients in immediate post-renal transplantation in treatment with TAC.Material and methodsRetrospective observational study carried out in a third-level general hospital.All patients with renal transplantation between September 2019 and September 2021 were included. The following variables were collected at immediate transplantation: demographic (sex, age), anthropometric (weight, height, body mass index (BMI)), monitoring-related (TAC concentration, ConTAC, corresponding to the first monitoring and at which optimal levels are reached, time relapsed from the start of TAC to the first level and the optimal level, number of determinations), clinical (creatinine(Cr) and renal clearance (ClCr) on the day of transplantation and day +7) and pharmacotherapeutics (antibody administered). Two protocols depending on the immunological risk were applied. Low-risk protocol (LR): basiliximab 20 mg on day 0 (day of transplantation) and on day +4, with immediate release TAC (single pre-transplant dose and maintenance dose). High-risk protocol (HR): thymoglobulin 1–1.5 mg/kg/day for 5–7 days and at the end, start with TAC. The target therapeutic interval of TAC in the first month post-renal transplant used was 10–15 ng/mL and the TAC dosage used was 0.15 mg/kg/day orally.The data collected were extracted from the GestLab and OrionClinic12 computer programs.ResultsThirty five patients were analysed, 57% men and 43% women with a mean age of 60±13 and 57±11years, respectively. Demographic variables, men: mean weight 78±11 kg, height 1.69±0.08 m and BMI 27±3 kg/m2, women: mean weight 67±12 kg, height 1.52±0.12 m and BMI 30±7 kg/m2). Eighteen patients (51.43%) were considered LR, receiving basiliximab + mean pre-transplant TAC dose of 10 mg and 17 patients (48.57%) as HR, receiving thymoglobulin. Mean TAC dosing regimen until first monitoring, with a mean time of 2 days: 7.25 mg/12 hours in LR and 6.14 mg/12 hours in HR. Mean total dose of TAC up to first monitoring: 33.47±13.42 mg in LR and 19.29±8.03 mg in HR. At first monitoring: LR, mean ConTAC of 22.89±8.04 ng/mL (83.3% >15 ng/mL, 11.11% 15 ng/mL, 35.3%
ISSN:2047-9956
2047-9964
DOI:10.1136/ejhpharm-2022-eahp.87