The effect of graft function on FK506 plasma levels, dosages, and renal function, with particular reference to the liver

Kareem Abu-Elmagd, John J. Fung, Mario Alessiani, Ashokkumar Jain, Raman Venkataramanan, Vijay S. Warty, Shunichi Takaya, Satoru Todo, William D. Shannon, Thomas E. Starzl

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Abstract

Plasma FK506 was studied in 49 liver, 13 heart, 3 double-lung or heart-lung, and 21 kidney recipients. The levels were correlated with the drug doses used, kidney function, and liver function. In all varieties of recipients, there was an early rise in the FK506 plasma levels that occurred at the time of intravenous administration of the drug. At the same time or shortly after, there were increases in serum creatinine that were transitory except in liver recipients with continuing suboptimal graft function. The quality of hepatic function dominated all aspects of FK506 management in the liver recipients. Those who received well-functioning grafts could be given about the same drug doses as recipients of kidneys and the thoracic organs. Liver recipients with defective grafts had astronomical rises in plasma FK506, a high incidence of renal failure, and probably increased neurotoxicity. In kidney transplant recipients, the FK506 plasma levels and doses were essentially the same in patients with prompt versus delayed renal function. These studies have highlighted the necessity, first, of close pharmacologic monitoring of patients who are given FK506 in the presence of abnormal liver function, and second, of using smaller intravenous induction doses than in past practice.

Original languageEnglish (US)
Pages (from-to)71-77
Number of pages7
JournalTransplantation
Volume52
Issue number1
DOIs
StatePublished - Jan 1 1991

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Tacrolimus
Transplants
Kidney
Liver
Pharmaceutical Preparations
Lung
Physiologic Monitoring
Intravenous Administration
Renal Insufficiency
Creatinine
Thorax
Incidence
Serum

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Abu-Elmagd, Kareem ; Fung, John J. ; Alessiani, Mario ; Jain, Ashokkumar ; Venkataramanan, Raman ; Warty, Vijay S. ; Takaya, Shunichi ; Todo, Satoru ; Shannon, William D. ; Starzl, Thomas E. / The effect of graft function on FK506 plasma levels, dosages, and renal function, with particular reference to the liver. In: Transplantation. 1991 ; Vol. 52, No. 1. pp. 71-77.
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abstract = "Plasma FK506 was studied in 49 liver, 13 heart, 3 double-lung or heart-lung, and 21 kidney recipients. The levels were correlated with the drug doses used, kidney function, and liver function. In all varieties of recipients, there was an early rise in the FK506 plasma levels that occurred at the time of intravenous administration of the drug. At the same time or shortly after, there were increases in serum creatinine that were transitory except in liver recipients with continuing suboptimal graft function. The quality of hepatic function dominated all aspects of FK506 management in the liver recipients. Those who received well-functioning grafts could be given about the same drug doses as recipients of kidneys and the thoracic organs. Liver recipients with defective grafts had astronomical rises in plasma FK506, a high incidence of renal failure, and probably increased neurotoxicity. In kidney transplant recipients, the FK506 plasma levels and doses were essentially the same in patients with prompt versus delayed renal function. These studies have highlighted the necessity, first, of close pharmacologic monitoring of patients who are given FK506 in the presence of abnormal liver function, and second, of using smaller intravenous induction doses than in past practice.",
author = "Kareem Abu-Elmagd and Fung, {John J.} and Mario Alessiani and Ashokkumar Jain and Raman Venkataramanan and Warty, {Vijay S.} and Shunichi Takaya and Satoru Todo and Shannon, {William D.} and Starzl, {Thomas E.}",
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Abu-Elmagd, K, Fung, JJ, Alessiani, M, Jain, A, Venkataramanan, R, Warty, VS, Takaya, S, Todo, S, Shannon, WD & Starzl, TE 1991, 'The effect of graft function on FK506 plasma levels, dosages, and renal function, with particular reference to the liver', Transplantation, vol. 52, no. 1, pp. 71-77. https://doi.org/10.1097/00007890-199107000-00015

The effect of graft function on FK506 plasma levels, dosages, and renal function, with particular reference to the liver. / Abu-Elmagd, Kareem; Fung, John J.; Alessiani, Mario; Jain, Ashokkumar; Venkataramanan, Raman; Warty, Vijay S.; Takaya, Shunichi; Todo, Satoru; Shannon, William D.; Starzl, Thomas E.

In: Transplantation, Vol. 52, No. 1, 01.01.1991, p. 71-77.

Research output: Contribution to journalArticle

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