Phannacokinetic analysis of tacrolimus in infants subject to living related liver transplantation and cardiac death liver transplantation

Abstract

Objective To analyze and compare the dosage, blood concentration and metabolic characteristics of Tacrolimus (Tac) for pediatric patients who underwent living related liver transplantation (LRLT) or donation after cardiac death liver transplantation (DDLT). Methods The clinical data of 75 liver transplantation pediatric patients from October 2012 to August 2015 were retrospectively analyzed. According to the different source of donors, the recipients were divided into two groups: LRLT group (40 cases) and DDLT group (35 cases). Results (1) Under the condition of same initial Tac dosage, the Tac dosage in LRLT group was less than in DDLT group during the first 28 days post-transplantation (P>0.05). However, the Tac dosage in DDLT group was significantly higher than in LRLT group on the second and third months after sugery (P=0.000). (2) Correlation analysis revealed that graft-recipient body weight ratio (GRWR) was correlated with Tac dosage (mg·kg-1·d-1) on the 14th day postoperative (LRLT group: r=0.579, P<0.05; DDLT group: r=0.583, P<0.05) and Tac concentration/dosage ratio (LRLT group: r=-0.607, P<0.05; DDLT group: r=-0.680, P<0.05). Conclusion Tac has a satisfactory anti-rejection effect on liver transplantation pediatric patients while the metabolism varied with each individual. There is a positive correlation between the early Tac dosage and the GRWR in both groups. It is necessary to set individualized Tac administration regimen according to the metabolic characteristics and GRWR. Key words: Liver transplantation; Living related donors; Cardiac death donors; Tacrolimus; metabolism