title: Tacrolimus in preventing transplant rejection in Chinese patients--optimizing use.
abstract: Tacrolimus is a product of fermentation of Streptomyces, and belongs to the family of calcineurin inhibitors. It is a widely used immunosuppressive drug for preventing solid-organ transplant rejection. Compared to cyclosporine, tacrolimus has greater immunosuppressive potency and a lower incidence of side effects. It has been accepted as first-line treatment after liver and kidney transplantation. Tacrolimus has specific features in Chinese transplant patients; its in vivo pharmacokinetics, treatment regimen, dose and administration, and adverse-effect profile are influenced by multiple factors, such as genetics and the spectrum of primary diseases in the Chinese population. We reviewed the clinical experience of tacrolimus use in Chinese liver- and kidney-transplant patients, including the pharmacology of tacrolimus, the immunosuppressive effects of tacrolimus versus cyclosporine, effects of different factors on tacrolimus metabolism on Chinese patients, personalized medicine, clinical safety profile, and patient satisfaction and adherence. This article provides guidance for the rational and efficient use of tacrolimus in Chinese organ-transplant patients.
authors.affiliation: Department of Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
authors.forename: Chuan-Jiang
authors.initials: CJ
authors.lastname: Li
authors.affiliation: Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Li
mesh_terms: D044466:Asian People / Q000235:genetics; D001711:Biotransformation / Q000235:genetics; D065095:Calcineurin Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002681:China; D005838:Genotype; D006084:Graft Rejection / Q000208:ethnology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects; D055118:Medication Adherence; D017060:Patient Satisfaction; D010597:Pharmacogenetics; D010641:Phenotype; D016559:Tacrolimus / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016559:Tacrolimus
keywords: Chinese; kidney transplant; liver transplantation; personalized medicine; tacrolimus