Publication: Whole-Blood Tacrolimus Trough Concentration in Renal Transplant Recipients at a Tertiary Care Center in Central Nepal: A Cross-sectional Study
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Institute of Medicine, Tribhuvan University
Abstract
Abstract:
Introduction
Tacrolimus, a widely used immunosuppressant for renal transplantation, requires careful monitoring due to its narrow therapeutic index and high pharmacokinetic variability. Hence, this study aimed to evaluate the whole blood tacrolimus trough levels in post-renal transplant patients at TUTH.
Methods
A total of 257 patients who had undergone kidney transplantation were included in this descriptive cross-sectional study Whole-blood tacrolimus concentration was measured using the ARCHITECT i1000SR analyzer (Abbott Diagnostics, North Chicago, USA) by CMIA. Ethical approval was taken from the Institutional Review Committee of TUTH [Ref. No.: 448(6-11) E2081/082].
Results
Among the 257 renal transplant recipients, 197(76.65%) were male and 60(23.35%) were female, with a mean age of 38.06±10.74 years. The mean tacrolimus trough level was 7.58±3.92 ng/mL, with a median of 6.8(IQR: 5.4- 9.1) ng/ml. Females had a slightly higher median tacrolimus concentration [7.2(IQR: 5.7- 9.1)] compared to males [6.8(IQR: 5.7- 9.1)]. Of the determinations, 175(68.09%) were within the therapeutic range (5-15 ng/mL), 68(26.46%) were below it, and 14(5.45%) had elevated tacrolimus levels.
Conclusions
The median tacrolimus trough level in this study was 6.8 ng/mL (IQR: 5.4–9.1), slightly higher but within the therapeutic range compared to similar studies done in similar settings. Monitoring of tacrolimus trough concentrations is of utmost importance in the management of kidney transplant recipients.
Description
Vijay Sharma
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Apeksha Niraula
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
https://orcid.org/0000-0003-2866-7969
Eans Tara Tuladhar
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Raju Kumar Dubey
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Aseem Bhattarai
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Mithileshwer Raut
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Anuradha Kadel
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
https://orcid.org/0000-0001-8122-6068
Nikita Kharal
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Srijana Sapkota
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Prakash Pokhrel
Department of Biochemistry, Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
Author
Keywords
Chemiluminescent microparticle immunoassay, Kidney transplantation, Tacrolimus, Therapeutic drug monitoring