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Updated: Jan 11, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
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Correlation Between Health Literacy and Tacrolimus Variability in Solid Organ Transplant Recipients.

Astrid Bacle1, Pauline Blanc-Petitjean1, Elouan Demay2

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Health literacy influences tacrolimus variability in transplant patients. Lower health literacy is linked to higher drug variability, suggesting targeted education can improve outcomes.

Keywords:
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Area of Science:

  • Transplantation immunology
  • Pharmacogenomics
  • Health services research

Background:

  • Immunosuppressive therapy adherence is vital for solid organ transplant success.
  • Tacrolimus intra-patient variability (%CV) predicts graft outcomes.
  • The impact of health literacy (HL) on tacrolimus variability is unknown.

Purpose of the Study:

  • To investigate the association between health literacy and tacrolimus intra-patient variability in solid organ transplant recipients.
  • To determine if health literacy is an independent predictor of tacrolimus variability.

Main Methods:

  • Prospective observational study of kidney, liver, and lung transplant recipients on tacrolimus.
  • Health literacy assessed using the Short Test of Functional Health Literacy in Adults (S-TOFHLA).
  • Tacrolimus %CV calculated over 6 months; linear regression used for analysis.

Main Results:

  • 98 patients included; insufficient HL associated with higher %CV (31.5% vs. 16.1%, p<0.05).
  • Health literacy independently associated with %CV (β=-1.60, SE=0.17, p<0.05) after adjustments.
  • Final model explained 53% of %CV variability.

Conclusions:

  • Health literacy is independently associated with tacrolimus variability in transplant patients.
  • Screening for HL and tailored educational interventions may enhance medication adherence and long-term transplant success.