title: Pretransplant Tacrolimus Dose Requirements Predict Early Posttransplant Dose Requirements in Blood Group AB0-Incompatible Kidney Transplant Recipients.
abstract: BACKGROUND
  The aim of this study was to investigate whether pretransplant tacrolimus (Tac) dose requirements of patients scheduled to undergo living donor kidney transplantation correlate with posttransplantation dose requirements.
  
  
  METHODS
  The predictive value of Tac dose requirements (defined as the ratio of the Tac predose concentration, C0, divided by the total daily Tac dose, D) pretransplantation on this same parameter posttransplantation was assessed retrospectively in a cohort of 57 AB0-incompatible kidney transplant recipients. These patients started immunosuppressive therapy 14 days before transplant surgery. All patients were using a stable dose of glucocorticoids and were at steady-state Tac exposure before transplantation.
  
  
  RESULTS
  Tac dose requirements immediately before transplantation (C0/Dbefore) explained 63% of the Tac dose requirements on day 3 after transplantation: r = 0.633 [F (1, 44) = 75.97, P < 0.01]. No other clinical and demographic variables predicted Tac dose requirements early after transplantation.
  
  
  CONCLUSIONS
  Steady-state Tac dose requirement before transplantation largely predicted posttransplantation Tac dose requirements in AB0-incompatible kidney transplant recipients. The importance of this finding is that the posttransplantation Tac dose can be individualized based on a patient's pretransplantation Tac concentration/dose ratio. Pretransplant Tac phenotyping therefore has the potential to improve transplantation outcomes.
authors.affiliation: Departments of *Hospital Pharmacy, Clinical Pharmacology Unit and†Internal Medicine, Division of Nephrology and Renal Transplantation, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
authors.forename: Nauras
authors.initials: N
authors.lastname: Shuker
authors.forename: Femke M
authors.initials: FM
authors.lastname: de Man
authors.forename: Annelies E
authors.initials: AE
authors.lastname: de Weerd
authors.forename: Madelon
authors.initials: M
authors.lastname: van Agteren
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.forename: Michiel G H
authors.initials: MG
authors.lastname: Betjes
authors.forename: Teun
authors.initials: T
authors.lastname: van Gelder
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Hesselink
mesh_terms: D000328:Adult; D000368:Aged; D001789:Blood Group Antigens / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000097:blood*; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage* / Q000097:blood*; D066027:Transplant Recipients; D055815:Young Adult
chemical_list: D001789:Blood Group Antigens; D007166:Immunosuppressive Agents; D016559:Tacrolimus