Optymalizacja leczenia takrolimusem po przeszczepieniu nerki

Tacrolimus (TAC), the most frequently used component of the immunosuppression regimen after kidney transplantation, is characterized by high pharmacokinetic and pharmacodynamic inter- as well as intra-patient variability. Its metabolism is affected by numerous genetic and clinical factors which requires adoption of individualized regimen. Simple practical strategies are therefore clearly needed to identify patients at risk of poor outcome who would benefit from a more personalized approach for TAC treatment. The different factors such as intra-patient variability of TAC, rate of metabolism, age, immunological risk, comorbidity, behavioral habits etc. should be taken into account in optimization and personalization of TAC therapy. This review shows the link between the pharmacokinetics of tacrolimus and the clinical needs of solid organ recipients.