PHÂN TÍCH KẾT QUẢ GIÁM SÁT NỒNG ĐỘ TACROLIMUS TRONG MÁU TRÊN BỆNH NHÂN SAU GHÉP GAN TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

This study described the results of tacrolimus therapeutic drug monitoring (TDM) on liver transplantation patients to manage the graft-versus-host disease and the drug toxicity. In addition, factors associated with tacrolimus trough concentration (C₀) were identified. The data of a cohort of 57 adult patients who underwent liver transplantation from 2017 to 2021 were retrospectively collected in Viet Duc Hospital. Tacrolimus trough concentrations post-liver transplantations showed a less variation and a downward trend at the later phase of follow up. The observed C₀ attained recommended therapeutic range of Immunosuppressive Drugs Scientific Committee of the International Association of Therapeutic Drug Monitoring and Clinical Toxicity (IATDMCT) in 2019 were about 40%. The intra-patient variability (IPV) of tacrolimus estimated by calculating the coefficient of variation (CV) of whole blood C₀ were from 3.5% to 105.4%. Through   mixed-linear regression analysis, the factors associated significantly with C₀ included maintenance dose (β coefficient = 1.894; p < 0.001), hematocrit (β coefficient = 1.053; p = 0.009) and maintenance dose (β coefficient = 3,930; p < 0.001), serum urea (β coefficient = 0,453; p < 0,001), respectively. In conclusion, tacrolimus C₀ and IPV showed significant variability in both early and late phases after transplantation, suggesting that the implementation of TDM with considering influenced factors was warrant.