Modelling Tacrolimus Auc in Acute and Chronic Liver Disease Immediately After Transplant



Toloughamari Z^{1, 3} ; Palizban AA¹ ; Tredger JM²
Source: Transplantationsmedizin: Organ der Deutschen Transplantationsgesellschaft Published:2004

Abstract

Objectives: To optimize therapy with tacrolimus the measurement of its concentration in blood is an integral part of the recipients care. The aim of this study was predicting area under the time-concentration curve (AUC) in acute and chronic liver disease immediately after liver transplant. Methods: Pharmacokinetic profiles for a period of 10 h, were obtained from seventy five adult liver recipients (30 acute liver failure and 45 chronic liver disease). Tacrolimus whole blood samples were analyzed using IMx analyzer. Statistical analyses were performed using SPSS for windows. Results: After subdividing patients on the basis of acute and chronic presentation examination of relationships between tacrolimus exposure and clinical biochemical markers showed that significant correlations existed only in the acutely presenting cases and there were associations between AUC (dose corrected) and serum albumin (r= -0.586, p= 0.0001) and total protein (r= - 0.544, p = 0.002). Conclusion: By incorporating variables influencing tacrolimus exposure immediately after transplant derived AUC in acutely presenting cases could be modeled with reasonable precision (r= 0.857) as: AUC=- (1.20x Alb) + (9.57 x PO4) - (0.98 x Prot) + (1.05 x Urea) + 84.7.