Abstract��
OBJECTIVE To investigate the application of therapeutic drug monitoring (TDM) in individualized immunosuppressive therapy in patients post renal transplantation. METHODS After renal transplantation, the patient received tacrolimus (Tac),mycophenolate mofetil(MMF) and prednisone to reduce the risk of rejection. The exposure levels of Tac and MMF were routinely monitored. Dose adjustments were performed according to the RESULTS of TDM combined with clinical signs and biochemical indexes. Abnormal liver function tests were developed on postoperative day 10 and timely therapy was initiated based on TDM and biochemical tests. RESULTS The trough concentrations of Tac and MMF were controlled in target therapeutic ranges with the utility of TDM. However, the patient showed abnormal hepatic function with significantly high level of Tac concentrations since 10 days post transplantation, which was considered to be Tac-induced liver injury. After modification of Tac dosage based on TDM, liver enzymes markedly improved. CONCULSION Although TDM of immunosuppressive agents has limitations, it has been the most powerful approach to guide clinical immunosuppressive therapy so far.
WANG Xiao-Xing,
LIU Xiao,
ZHANG Xiang-Lin-*
.Individualized Medicine after Tacrolimus-Induced liver Injury in a Patient Post renal Transplantation Based on therapeutic drug monitoring[J] Chinese Pharmaceutical Journal, 2014,V49(19): 1763-1765
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