HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 0091270009333853v1 49/7/789    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Google Scholar Articles by Fukudo, M. Articles by Inui, K.-i. PubMed PubMed Citation Articles by Fukudo, M. Articles by Inui, K.-i. Social Bookmarking                         What's this?

Prospective Evaluation of the Bayesian Method for Individualizing Tacrolimus Dose Early After Living-Donor Liver Transplantation

From the Department of Pharmacy, Kyoto University Hospital, Faculty of Medicine, Kyoto University, Japan (Dr Fukudo, Dr Yano, Ms Shinsako, Dr Katsura, Dr Inui); and Department of Surgery, Graduate School of Medicine, Kyoto University (Dr Takada, Dr Uemoto).

Tacrolimus is widely used to prevent acute rejection after transplantation, but achieving therapeutic blood concentrations of tacrolimus is often difficult because of large pharmacokinetic variability. In this study, the applicability of the Bayesian method to individualize tacrolimus dose was prospectively examined. Twenty adult recipients (Bayesian group) and another 20 adult patients (control group), all of whom underwent living-donor liver transplantation, were enrolled in this study. In the Bayesian group, the dose of tacrolimus during the first 3 and 4 weeks after surgery was adjusted with the Bayesian method using a population pharmacokinetic model, targeting a trough level of 5 to 12 ng/mL. The interindividual variability in tacrolimus concentrations was significantly reduced in the Bayesian group compared with the control group (average percentage coefficient of variation for all occasions, 32% vs 44% and 31% vs 39% in the first 3 and 4 weeks, respectively). In addition, more patients achieved the target concentrations in the Bayesian group than in the control group (average for all occasions, 85% vs 59% and 83% vs 70% in the first 3 and 4 weeks, respectively). These findings suggest that the Bayesian method can be used to calculate maintenance doses of tacrolimus in adult patients early after living-donor liver transplantation.

Key Words: Tacrolimus • pharmacokinetics • Bayesian • dose optimization • living-donor liver transplantation

Address for reprints: Ken-ichi Inui, PhD, Department of Pharmacy, Kyoto University Hospital, Sakyo-ku, Kyoto 606-8507, Japan; e-mail address: inui{at}kuhp.kyoto-u.ac.jp.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?