title: Impact of molecular adsorbent recirculating system therapy on tacrolimus elimination: a case report.
abstract: BACKGROUND
  We report a unique case which quantifies the effect of molecular adsorbent recirculating system (MARS [Gambro, Sweden]) therapy on blood concentrations of tacrolimus in a patient treated for refractory pruritus associated with recurrent hepatitis C of the liver allograft. Tacrolimus is a low-molecular-weight, highly protein-bound drug with the potential to be removed during MARS therapy.
  
  
  METHODS
  Results of therapeutic drug monitoring revealed extracorporeal tacrolimus elimination accounted for only 0.3% of total drug removal during the session.
  
  
  CONCLUSIONS
  Although no explanation can be offered as to why MARS contributed so little to overall tacrolimus elimination, the data clearly show minimal impact of MARS on tacrolimus blood level.
authors.affiliation: Department of Pharmacy Services, Mayo Clinic Hospital, Rochester, Minnesota. Electronic address: personett.heather@mayo.edu.
authors.forename: H A
authors.initials: HA
authors.lastname: Personett
authors.affiliation: Department of Pharmacy Services, Mayo Clinic Hospital, Rochester, Minnesota.
authors.forename: S L
authors.initials: SL
authors.lastname: Larson
authors.affiliation: Department of Pharmacy Services, Mayo Clinic Hospital, Rochester, Minnesota.
authors.forename: E N
authors.initials: EN
authors.lastname: Frazee
authors.affiliation: Department of Transplantation Surgery, Mayo Clinic Hospital, Rochester, Minnesota.
authors.forename: S L
authors.initials: SL
authors.lastname: Nyberg
authors.affiliation: Department of Nephrology and Hypertension, Mayo Clinic Hospital, Rochester, Minnesota.
authors.forename: N
authors.initials: N
authors.lastname: Leung
authors.affiliation: Department of Nephrology and Hypertension, Mayo Clinic Hospital, Rochester, Minnesota.
authors.forename: Z M
authors.initials: ZM
authors.lastname: El-Zoghby
mesh_terms: D000368:Aged; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood* / Q000493:pharmacokinetics; D016031:Liver Transplantation; D008297:Male; D012086:Reoperation; D016060:Sorption Detoxification / Q000379:methods*; D016559:Tacrolimus / Q000097:blood* / Q000493:pharmacokinetics
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus