Chapters authored
Analysis of the Behavior of Plasma Concentrations of Tacrolimus in Adult Patients with Liver Transplantation: Adverse Reactions and Drug Interactions and Their Relevance to Patient Safety
Organ transplantation is a medical treatment often used to restore the function of vital organs. Tacrolimus is one of the most widely used drugs in the immunosuppressive treatment of liver transplants. Aims: To analyze plasma concentrations of tacrolimus in adult liver transplant patients and to characterize adverse effects and drug interactions. Design: retrospective observational studies. The study included 32 patients, of whom 22 were male and 10 female. The average values and range of tacrolimus obtained showed a mean of 8.7 SD 3.2. Low values were found in seventy-five cases, with a percentage of 54.8%. The values within the expected had a frequency of fifty-three times with a percentage of 38.7%. Finally, the frequency of high values was nine times with a percentage of 6.5%. A total of 36 RAM types were found. It was determined that the majority of the ADRs were of moderate damage (13) of 46.4%, while 39.3% of the ADRs were of slight damage (11), 14.3% were of severe damage (4) and no ADR was incidental. Clinically relevant drug interactions in this group of patients were 16.7% contraindicated, 16.7% adjustments based on close follow-up, and 66.6% use with routine follow-up. Similar to the interactions present in the 2013 EMA data sheet. Plasma tacrolimus concentrations are within the range of 38.7% in male patients and 40.8% in female patients. 61.3% of male patients and 59.2% of female patients do not reach the expected tacrolimus plasma levels of 8.0−11.0 ng/ml, similar to those presented in the 2009 FDA data sheet. There were 220 ADRs in this sample of 32 liver transplant patients.
Part of the book: Controversies in Liver Transplantation