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Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Renal Drug Excretion: Glomerular Filtration01:02

Renal Drug Excretion: Glomerular Filtration

The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles.

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Related Experiment Video

Updated: Jun 5, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Conversion from Prograf to Advagraf among kidney transplant recipients results in sustained decrease in tacrolimus

Jean-Michel Hougardy1, Nilufer Broeders, Mireille Kianda

  • 1Renal Transplantation Clinic, Department of Nephrology, Clinique Universitaire Hôpital Erasme, 808 Route de Lennik, Brussels, Belgium. jehougar@ulb.ac.be

Transplantation
|December 31, 2010
PubMed
Summary
This summary is machine-generated.

Switching kidney transplant patients from Prograf to Advagraf, a slow-release tacrolimus, resulted in increased doses but decreased blood levels. Close monitoring is advised due to lower tacrolimus exposure with Advagraf.

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Last Updated: Jun 5, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

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Published on: November 8, 2015

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07:13

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

Area of Science:

  • Nephrology
  • Transplant Medicine
  • Pharmacology

Background:

  • Advagraf is a once-daily, slow-release formulation of tacrolimus.
  • Potential benefits include improved adherence and reduced peak concentration toxicity.
  • This study investigates tacrolimus dosing and blood levels after switching from Prograf to Advagraf.

Purpose of the Study:

  • To evaluate tacrolimus daily doses and blood levels in kidney transplant recipients after conversion from Prograf to Advagraf.
  • To compare tacrolimus exposure between the two formulations.

Main Methods:

  • Retrospective analysis of 55 kidney transplant patients switched from Prograf to Advagraf.
  • Tacrolimus doses and trough blood levels were monitored pre- and post-conversion (up to 6 months).

Main Results:

  • Tacrolimus daily doses increased significantly post-conversion (0.063 to 0.081 mg/kg).
  • Trough tacrolimus levels decreased significantly (8.05 to 6.30 ng/mL) by 6 months.
  • 35% of patients had >30% decrease in trough levels; creatinine and rejection rates remained stable.

Conclusions:

  • Switching to Advagraf led to a significant decrease in tacrolimus exposure, contrary to expectations.
  • Increased Advagraf dosing is required to maintain therapeutic levels.
  • Conversion from Prograf to Advagraf necessitates close medical supervision.