Assuntos
Hidrocarboneto de Aril Hidroxilases/genética , Imunossupressores/uso terapêutico , Transplante de Rim/fisiologia , Oxigenases de Função Mista/genética , Inibidores da Bomba de Prótons , Tacrolimo/uso terapêutico , 2-Piridinilmetilsulfinilbenzimidazóis , Benzimidazóis/uso terapêutico , Citocromo P-450 CYP2C19 , Interações Medicamentosas , Famotidina/uso terapêutico , Feminino , Humanos , Lansoprazol , Masculino , Pessoa de Meia-Idade , Omeprazol/análogos & derivados , Omeprazol/uso terapêutico , RabeprazolRESUMO
To examine the effects of ascites on tacrolimus disposition, the authors measured tacrolimus concentration in blood and ascitic fluid from a patient with a living related liver transplant recipient who required removal of 500 to 2400 mL ascitic fluid daily. Tacrolimus levels in ascitic fluid ranged from 0.07 to 0.29 ng/mL and in whole blood from 7.5 to 20.3 ng/mL. The tacrolimus concentration in ascitic fluid positively correlated with that in whole blood ( r = 0.878, P <0.0001). Because the amounts of tacrolimus excreted into the ascitic fluid corresponded to only 0.01% to 0.09% of the dose administered, the authors concluded that the effects of ascites on tacrolimus disposition were negligible even though large amounts of ascitic fluid were drained regularly.