Studying the Blood Trough Level of Tacrolimus on Patients after Kidney Transplant at the Uronephreulogical Department, Bach Mai Hospital, Vietnam

Abstract

Tacrolimus, a calcineurin inhibitor, is a first-choice drug for the anti-rejection treatment regimen after kidney transplantation. The daily adjusted Tacrolimus dose by therapeutic drug monitoring is essential for patients to achieve optimal effects and minimize complications. We conducted a retrospective analysis of 70 kidney transplant patients at Bach Mai Hospital from January 2019 to the end of June 2020 to monitor changes in the blood trough level of Tacrolimus over time and analyze some risk factors affecting the blood trough level of Tacrolimus after a kidney transplant. Total whole-blood samples were collected at 6 time points: pre-transplant, on transplant day, and the 1st, 2nd, 4th, and 8th day after surgery. During the study, we recorded 4 cases with accelerated acute rejection with the blood trough level of Tacrolimus on the first day after transplantation of 5.325 ± 1.531 ng/mL and lower than the medium level in the remaining group of patients 10.371 ± 4.550 ng/mL at the same time (p = 0.031). There was no significant difference between the two groups of patients in age, gender, BMI, chronic disease status (hypertension, hepatitis C, type 2 diabetes), pre-transplant blood urea, and serum creatinine concentrations. These characteristics were included in the linear regression models which affected the blood trough level of Tacrolimus. This showed that none of the above risk factors had a significant effect on the blood trough level of Tacrolimus on the first day after transplantation (p > 0.05).