Tacrolimus in preventing transplant rejection in Chinese patients--optimizing use.
Tacrolimus in preventing transplant rejection in Chinese patients--optimizing use.
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DOI：
10.2147/dddt.s41349
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Li L
中科院分区：
文献类型：
--
作者：
Li CJ;Li L
他克莫司是链霉菌发酵的产物，属于钙调神经磷酸酶抑制剂家族。它是一种广泛使用的免疫抑制药物，用于预防实体器官移植排斥反应。与环孢素相比，他克莫司具有更强的免疫抑制效力和更低的副作用发生率。它已被接受为肝肾移植后的一线治疗。他克莫司在中国移植患者中具有特殊性；其体内药代动力学、治疗方案、剂量和给药以及不良反应情况受多种因素的影响，如遗传学和中国人群的原发病谱。我们综述了中国肝肾移植患者使用他克莫司的临床经验，包括他克莫司的药理作用，他克莫司与环孢素的免疫抑制作用，不同因素对中国患者他克莫司代谢的影响，个性化用药，临床安全概况，患者满意度和依从性。为我国器官移植患者合理有效地应用他克莫司提供指导。
Tacrolimus is a product of fermentation of Streptomyces, and belongs to the family of calcineurin inhibitors. It is a widely used immunosuppressive drug for preventing solid-organ transplant rejection. Compared to cyclosporine, tacrolimus has greater immunosuppressive potency and a lower incidence of side effects. It has been accepted as first-line treatment after liver and kidney transplantation. Tacrolimus has specific features in Chinese transplant patients; its in vivo pharmacokinetics, treatment regimen, dose and administration, and adverse-effect profile are influenced by multiple factors, such as genetics and the spectrum of primary diseases in the Chinese population. We reviewed the clinical experience of tacrolimus use in Chinese liver- and kidney-transplant patients, including the pharmacology of tacrolimus, the immunosuppressive effects of tacrolimus versus cyclosporine, effects of different factors on tacrolimus metabolism on Chinese patients, personalized medicine, clinical safety profile, and patient satisfaction and adherence. This article provides guidance for the rational and efficient use of tacrolimus in Chinese organ-transplant patients.