Tacrolimus Intrapatient Variability as a Biomarker in Solid Organ Transplantation

Area of Science:

• Nephrology
• Immunology
• Transplantation Medicine

Background:

• Tacrolimus is a key calcineurin inhibitor in solid organ transplantation.
• Tacrolimus exhibits significant inter- and intrapatient variability.
• Tacrolimus intrapatient variability (Tac-IPV) is emerging as a predictive biomarker for transplant outcomes.

Purpose of the Study:

• To systematically review the literature on Tac-IPV's influence on solid organ transplantation outcomes.
• To summarize current knowledge and identify gaps in understanding Tac-IPV as a biomarker.

Main Methods:

• Systematic literature review.
• Data collection from inception to September 18, 2024.
• Analysis of studies evaluating Tac-IPV in various solid organ transplant modalities.

Main Results:

• Existing literature shows Tac-IPV's potential predictive value across different transplant types.
• Lack of consensus on the optimal method for measuring Tac-IPV.
• No established ideal post-transplantation period for Tac-IPV evaluation.
• Proposed cut-off points for Tac-IPV, primarily from adult kidney transplant studies, may not generalize.

Conclusions:

• Tac-IPV is a promising biomarker in solid organ transplantation.
• Further research is needed to standardize Tac-IPV measurement and determine optimal evaluation timing.
• Standardization is crucial for applying Tac-IPV across diverse transplant types.