title: Tacrolimus for the prevention and treatment of rejection of solid organ transplants.
abstract: Since its introduction to the antirejection armamentarium in 1994, tacrolimus has become the workhorse of transplant professionals for avoidance of solid organ transplant rejection. Not only does tacrolimus have potent immunosuppressive qualities that prevent rejection, but dosing is straight forward and it is generally well tolerated. However, in the long term, conditions such as calcineurin inhibitor nephrotoxicity can become a problem. A discussion of the compound, the pharmacokinetics, history, and current approved uses for tacrolimus is described. Indeed, tacrolimus is the most important drug for preventing transplant rejection. However, the increased appreciation for significant side effects, particularly in the long term, has led to building interest in new agents with different mechanisms of action and different metabolism.
authors.affiliation: a Division of Transplantation, Department of Surgery , University of Wisconsin , Madison , VA , USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Scalea
authors.affiliation: b School of Medicine , University of Virginia , Charlottesville , VA , USA.
authors.forename: Shoshana T
authors.initials: ST
authors.lastname: Levi
authors.affiliation: c Department of Pharmacy Services , University of Virginia Health System , Charlottesville , VA , USA.
authors.forename: Winston
authors.initials: W
authors.lastname: Ally
authors.affiliation: b School of Medicine , University of Virginia , Charlottesville , VA , USA.|d Division of Transplantation, Department of Surgery , University of Virginia , Charlottesville , VA , USA.
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Brayman
mesh_terms: D000818:Animals; D065095:Calcineurin Inhibitors / Q000009:adverse effects / Q000276:immunology*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000276:immunology*; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D016377:Organ Transplantation; D016559:Tacrolimus / Q000009:adverse effects / Q000276:immunology*
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016559:Tacrolimus
keywords: Transplant; antirejection; calcineurin inhibition; maintenance immunosuppression