Monitoring and regularity of tacrolimus in patients subject to cadaveric liver transplantation and living-donor partial liver transplantation / 中华器官移植杂志

ABSTRACT

Objective To analyze and compare the therapeutic drug monitoring (TDM) and regularity of tacrolimus in deceased donor liver transplantation (DDLT) and living-donor partial liver transplantation (LDLT) the therapeutic drug monitoring (TDM) and regularity of tacrolimus.Method The clinical data of 68 patients undergoing liver transplantation from January 2010 to October 2011 were analyzed retrospectively.Thirty cases underwent LDLT as group A,and the remaining 37 underwent DDLT as group B.Result The time to reach therapeutic window was shorter in group A(3.9 ± 0.7 days) than in group B (6.5 ± 1.0 days,P＜0.01).The tacrolimus dosage in group A was significantly less than that in group B during the first 28 days post-transplantation.However,the tacrolimus dosage approached gradually and tended to be consistent after 28 days.On the postoperative day 7,14,21 and 28,the Tacrolimus dosage in group A was 72.37％,79.31％,90.11％ and 95.45％ of that in group B respectively.Concentration-dose ratio in group B was in a steady state (80-90 g/L).Concentration-dose ratio in group A was decreased with time,culminating at 28th day and close to that in group B.Correlation analysis revealed that graft recipient weight ratio(GRWR) had a significantly positive correlation with the tacrolimus dosage on the first 7 days (r =0.557) and a significantly negative correlation with the tacrolimus concentration/dose ratio (r =-0.578).Conclusion The early tacrolimus dosages in patients subject to LDLT were correlated significantly with the GRWR.The early tacrolimus dosages in patients undergoing LDLT were about 70％ of those in patients undergoing LDLT.However,with the regeneration of the liver,they tended to be consistent after 28 days.