Optimization of individualized tacrolimus dosing regimen after liver transplantation based on genetic testing and blood concentration monitoring techniques
Tacrolimus,a widely used clinical calcium-modulated neural phosphatase inhibitor,is used as a first-line a-gent for the prevention and treatment of acute rejection after liver transplantation.However,in clinical applications,tacrolimus exhibits a narrow therapeutic window and large individual differences in pharmacokinetics,and low concentrations of tacrolimus in the early post-transplant period may induce rejection;Whereas high concentrations of tacrolimus may lead to nephrotoxicity and/or neurotoxicity,so in-depth studies on the factors influencing the pharmacokinetics of tacrolimus are essential.In this article,we reviewed the clinical need for genetic testing and blood concentration monitoring in patients by searching the Chinese Network of Knowledge(CNKI),Wipro,Wanfang,and PubMed databases,and concluded that dosing based on genetic polymorphisms and the strategy of finding the optimal sampling point of the area under the curve at the time of substitution may be helpful to clinicians in predicting the optimal starting dosage of tacrolimus,which can help in the adjustment of the maintenance regimen,and is expected to reduce the incidence of adverse effects.
万方数据
维普
