Scientific article
Case report
Open access

Case Report: Low Hematocrit Leading to Tacrolimus Toxicity

Published inFrontiers in pharmacology, vol. 12, 717148
Publication date2021-08-16
First online date2021-08-16

Tacrolimus is a calcineurin inhibitor characterized by a narrow therapeutic index and high intra- and inter-individual pharmacokinetic variability. Therapeutic drug monitoring in whole-blood is the standard monitoring procedure. However, tacrolimus extensively binds to erythrocytes, and tacrolimus whole-blood distribution and whole-blood trough concentrations are strongly affected by hematocrit. High whole-blood tacrolimus concentrations at low hematocrit may result in high unbound plasma concentrations and increased toxicity. We present the case of a 16-year-old girl with kidney and liver transplant in whom low concentrations of tacrolimus in the context of low hematocrit led to significant increase in the dosage of tacrolimus and participate, along with a genetic polymorphism of ABCB1 , in nephrotoxicity.

  • ABCB1
  • Hematocrit
  • Monitoring
  • Pharmacogenetic
  • Pharmacokinetic
  • Subtherapeutic
  • Tacrolimus
  • Toxicity
Citation (ISO format)
PILETTA-ZANIN, Alexandre et al. Case Report: Low Hematocrit Leading to Tacrolimus Toxicity. In: Frontiers in pharmacology, 2021, vol. 12, p. 717148. doi: 10.3389/fphar.2021.717148
Main files (1)
Article (Published version)
ISSN of the journal1663-9812

Technical informations

Creation11/26/2021 1:36:00 PM
First validation11/26/2021 1:36:00 PM
Update time03/16/2023 2:39:51 AM
Status update03/16/2023 2:39:50 AM
Last indexation05/06/2024 9:56:04 AM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack