Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (53): 9911-9915.doi: 10.3969/j.issn.2095-4344.2012.53.006

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Variation of tacrolimus trough levels in renal transplant recipients during acute diarrhea

Feng Xiao-fang1, Wang Li-ming2, Min Min1, Zuo Fu-jie1, Zhou Mei-sheng2   

  1. 1Department of Renal Transplantation Rehabilitation, Zhabei Central Hospital (Zhabei Branch of Shanghai Changzheng Hospital), Shanghai 200070, China
    2Organ Transplant Center of Shanghai Changzheng Hospital, Shanghai 200070, China
  • Received:2012-02-04 Revised:2012-04-01 Online:2012-12-30 Published:2012-12-30
  • Contact: Wang Li-ming, Doctor, Chief physician, Organ Transplant Center of Shanghai Changzheng Hospital, Shanghai 200070, China wt2530@yahoo.com.cn
  • About author:Feng Xiao-fang★, Master, Attending physician, Department of Renal Transplantation Rehabilitation, Zhabei Central Hospital (Zhabei Branch of Shanghai Changzheng Hospital), shanghai 200070, China fengxiaofang1980@sina.com

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Abstract:

BACKGROUND: For a long time, the organ transplant workers pay more attentions to the intestinal adverse effects of mycophenolate mofetil; however, the relationship between tacrolimus and diarrhea has not attracted much attention.
OBJECTIVE: To observe the change of tacrolimus trough levels and treatment efficacy in renal transplant recipients during of acute diarrhea.
METHODS: Ninety cases with acute diarrhea were observed after renal transplantation, tacrolimus+mycophnolate mofetil+prednisone triple immunosuppressive regimen was used to detect the tacrolimus rough levels and related etiological laboratory before, during and after acute diarrhea. Among 72 cases with increased tacrolimus trough levels, 48 cases with negative etiological examination were randomly divided into two groups: group A (n=24) and group B (n=24). The patients in group A only reduced the dose of tacrolimus in the course of the treatment and the patients in group B reduced the dose of tacrolimus and mycophnolate mofetil. We observed the efficacy and duration time of tacrolimus trough levels elevated.
RESULTS AND CONCLUSION: There was no significant difference in the efficacy and the duration time of tacrolimus trough levels elevated between two groups. Diarrhea following kidney transplantation could significantly result in abnormally elevation of tacrolimus trough levels. We should reduce the dose of tacrolimus and increase the monitoring frequency of tacrolimus trough levels during diarrhea, which can reduce the incidence of adverse effects; in the course of the treatment, we should not to reduce the dose of mycophnolate mofetil, as it can increase the incidence of rejection rate.

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