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World J Transplant. Feb 24, 2017; 7(1): 26-33
Published online Feb 24, 2017. doi: 10.5500/wjt.v7.i1.26
Influence of tacrolimus metabolism rate on renal function after solid organ transplantation
Gerold Thölking, Hans Ulrich Gerth, Katharina Schuette-Nuetgen, Stefan Reuter
Gerold Thölking, Hans Ulrich Gerth, Katharina Schuette-Nuetgen, Stefan Reuter, Division of General Internal Medicine, Nephrology and Rheumatology, Department of Medicine D, University Hospital of Münster, 48149 Münster, Germany
Author contributions: Thölking G wrote the paper, analyzed the data and designed the study; Gerth HU collected the data and wrote the paper; Schuette-Nuetgen K collected the data and wrote the paper; Reuter S designed the study and wrote the paper.
Conflict-of-interest statement: Gerold Thölking, Hans Ulrich Gerth and Katharina Schuette-Nuetgen declare no conflict of interests for this article; Stefan Reuter declares that he has received travel support from Astellas and lecture fees from Chiesi.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gerold Thölking, MD, Division of General Internal Medicine, Nephrology and Rheumatology, Department of Medicine D, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149 Münster, Germany. gerold.thoelking@ukmuenster.de
Telephone: +49-251-8348001 Fax: +49-251-8346979
Received: October 5, 2016
Peer-review started: October 7, 2016
First decision: November 11, 2016
Revised: November 22, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: February 24, 2017
Processing time: 139 Days and 12.3 Hours
Core Tip

Core tip: The calcineurin inhibitor tacrolimus (TAC) is the mainstay of the immunosuppressive regimen after solid organ transplantation. Nevertheless, TAC can cause nephrotoxicity even at low blood trough levels. Thus, other factors than the TAC trough level might be responsible for kidney injury. Recently published studies showed a strong association between fast TAC metabolism and nephrotoxicity as well as BK virus infection. The TAC metabolism rate defined as the TAC concentration/dose ratio is a cost neutral tool to identify patients at risk for TAC-associated decline in renal function after transplantation.