Therapeutic Drug Monitoring of Mycophenolic Acid Can Be Used as Predictor of Clinical Events for Kidney Transplant Recipients Treated With Mycophenolate Mofetil

2006 ◽  
Vol 38 (7) ◽  
pp. 2048-2050 ◽  
Author(s):  
Y.P. Lu ◽  
Y.C. Zhu ◽  
M.Z. Liang ◽  
F. Nan ◽  
Q. Yu ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Therapeutic Drug Monitoring ◽  
Kidney Transplant ◽  
Mycophenolic Acid ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Clinical Events

scholarly journals Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring

2021 ◽  
Vol 11 (11) ◽  
pp. 1224
Author(s):  
Eisuke Nakamura ◽  
Tadashi Sofue ◽  
Yasushi Kunisho ◽  
Keisuke Onishi ◽  
Kazunori Yamaguchi ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Therapeutic Drug Monitoring ◽  
Kidney Transplant ◽  
Mycophenolic Acid ◽  
Drug Monitoring ◽  
Target Range ◽  
Therapeutic Drug ◽  
Prognostic Impact ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Mycophenolate mofetil is a key immunosuppressant that is metabolized into mycophenolic acid (MPA). The prognostic impact of MPA-focused therapeutic drug monitoring on allograft prognosis has not been determined in kidney transplant recipients with diabetes. In this study, we assessed the pharmacokinetics of MPA and allograft prognosis in recipients with diabetes. This study retrospectively analyzed 64 adult kidney transplant recipients. MPA blood concentration data (e.g., the time to the maximum concentration (Tmax), and the area under the concentration–time curve from 0 to 12 h (AUC0–12)) were collected at 3 weeks and 3 months after kidney transplantation. Of the 64 recipients, 15 had pre-existing diabetes. At 3 months after kidney transplantation, the Tmax of MPA was significantly longer in recipients with diabetes (mean (standard deviation): 2.8 (2.1) h) than in recipients without diabetes (1.9 (1.1) h, p = 0.02). However, the allograft estimated glomerular filtration rate and acute rejection rate, including borderline change, did not differ according to the diabetes status in patients with adjusted AUC0–12 of MPA within the target range. In conclusion, a longer Tmax of MPA was observed in recipients with diabetes; however, acceptable allograft prognosis was observed in kidney transplant recipients with diabetes and a sufficient AUC0–12 of MPA.

Pharmacokinetic Advantages of Two-Hour Post-Dose Cyclosporin A Level for the Therapeutic Drug Monitoring in Stable Chinese Kidney Transplant Recipients

2005 ◽  
Vol 99 (3) ◽  
pp. c68-c72 ◽  
Author(s):  
Chi-Bon Leung ◽  
Cheuk-Chun Szeto ◽  
Chung-Shun Ho ◽  
Wai-Keung Law ◽  
Christopher Wai-Kei Lam ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Cyclosporin A ◽  
Kidney Transplant ◽  
Drug Monitoring ◽  
Therapeutic Drug ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Dose

Impact of a Clinical Solid Organ Transplant Pharmacist on Tacrolimus Nephrotoxicity, Therapeutic Drug Monitoring, and Institutional Revenue Generation in Adult Kidney Transplant Recipients

2016 ◽  
Vol 26 (4) ◽  
pp. 314-321 ◽  
Author(s):  
Shawn P. Griffin ◽  
Joelle E. Nelson
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Kidney Transplant ◽  
Drug Monitoring ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Therapeutic Drug ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Adult Kidney

Context: Tacrolimus requires close therapeutic drug monitoring (TDM) to ensure efficacy and minimize adverse effects. Pharmacists are uniquely positioned on transplant teams to interpret levels and recommend therapy modifications. Their impact in the immediate postoperative setting has not been described previously. Objective: To evaluate the impact of a clinical solid organ transplant pharmacist on nephrotoxicity, TDM, and revenue generation in adult kidney transplant recipients on tacrolimus. Design, Setting, and Patients: Retrospective assessment of adult kidney transplant recipients at University of Florida Health Shands Hospital. Intervention: A transplant pharmacist rounded 5 days a week and made medication recommendations on transplant recipients—including tacrolimus dose modifications based on levels. Pharmacy services were expanded to include medication reconciliation, medication counseling, and delivery of discharge medications to bedside. Main Outcome Measure: Incidence of nephrotoxicity during tacrolimus exposure. Results: Of the 70 kidney transplant recipients in the postpharmacist cohort, 18 (25.7%) experienced nephrotoxicity while on tacrolimus, compared to 18 (25%) of the 72 in the prepharmacist cohort ( P = .922). A significantly greater proportion of recipients who experienced nephrotoxicity were male, had hypertension, or experienced delayed or slow graft function. The rate of appropriately drawn tacrolimus troughs significantly increased from 23.4% to 30.3% in the postpharmacist cohort ( P < .001). The median outpatient pharmacy revenue generated per recipient significantly increased from US$345.49 (interquartile range [IQR]: 0-4727.56) to US$4834.95 per recipient (IQR: 3592.78-6224.60; P < .001). The length of stay (7 days, IQR: 6-9, vs 8 days, IQR: 6-9; P = .107) and the 30-day readmission rate were similar between groups (20.8% vs 21.4%; P = .931).

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