Morais MC, Soares ME, Costa G, Guerra L, Vaz N, Codes L, Bittencourt PL. Impact of tacrolimus intra-patient variability in adverse outcomes after organ transplantation. World J Transplant 2023; 13(5): 254-263 [PMID: 37746041 DOI: 10.5500/wjt.v13.i5.254]
Corresponding Author of This Article
Paulo Lisboa Bittencourt, MD, PhD, Chief Doctor, Unit of Gastroenterology and Hepatology, Portuguese Hospital, 914 Av. Princesa Isabel, Barra, Salvador 40130-030, Bahia, Brazil. plbbr@uol.com.br
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Sep 18, 2023; 13(5): 254-263 Published online Sep 18, 2023. doi: 10.5500/wjt.v13.i5.254
Impact of tacrolimus intra-patient variability in adverse outcomes after organ transplantation
Maria Clara Morais, Maria Eduarda Soares, Gabriela Costa, Laura Guerra, Nayana Vaz, Liana Codes, Paulo Lisboa Bittencourt
Maria Clara Morais, Gabriela Costa, Laura Guerra, Nayana Vaz, Liana Codes, Paulo Lisboa Bittencourt, School of Medicine, Bahiana School of Medicine and Public Health, Salvador 40290-000, Bahia, Brazil
Maria Eduarda Soares, School of Medicine, Federal University of Bahia, Salvador 40110-100, Bahia, Brazil
Nayana Vaz, Liana Codes, Paulo Lisboa Bittencourt, Unit of Gastroenterology and Hepatology, Portuguese Hospital, Salvador 40130-030, Bahia, Brazil
Author contributions: Morais MC, Codes L, and Bittencourt PL contributed to concept and design; Morais MC, Costa G, Guerra L, Vaz N, Codes L, and Bittencourt PL contributed to drafting of the manuscript; and all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Paulo Lisboa Bittencourt, MD, PhD, Chief Doctor, Unit of Gastroenterology and Hepatology, Portuguese Hospital, 914 Av. Princesa Isabel, Barra, Salvador 40130-030, Bahia, Brazil. plbbr@uol.com.br
Received: June 28, 2023 Peer-review started: June 28, 2023 First decision: July 19, 2023 Revised: July 31, 2023 Accepted: August 11, 2023 Article in press: August 11, 2023 Published online: September 18, 2023
Abstract
Tacrolimus (Tac) is currently the most common calcineurin-inhibitor employed in solid organ transplantation. High intra-patient variability (IPV) of Tac (Tac IPV) has been associated with an increased risk of immune-mediated rejection and poor outcomes after kidney transplantation. Few data are available concerning the impact of high Tac IPV in non-kidney transplants. However, even in kidney transplantation, there is still a controversy whether high Tac IPV is indeed detrimental in respect to graft and/or patient survival. This may be due to different methods employed to evaluate IPV and distinct time frames adopted to assess graft and patient survival in those reports published up to now in the literature. Little is also known about the influence of high Tac IPV in the development of other untoward adverse events, update of the current knowledge regarding the impact of Tac IPV in different outcomes following kidney, liver, heart, lung, and pancreas transplantation to better evaluate its use in clinical practice.
Core Tip: Tacrolimus is widely used after solid organ transplantation. High intra-patient variability of tacrolimus (Tac IPV) has been associated with poor graft and patient survival. This review summarizes current evidence regarding the impact of high Tac IPV in several outcomes after kidney, liver, heart, lung and pancreas transplantation.
