Association Between the Intracellular Tacrolimus Concentration in CD3+ T Lymphocytes and CD14+ Monocytes and Acute Kidney Transplant Rejection

Background: Intracellular tacrolimus concentration in peripheral blood mononuclear cells (PBMCs) (TAC[PBMC]) has been proposed to better represent its active concentration than its whole blood concentration. As tacrolimus acts on T lymphocytes and other white blood cells, including monocytes, we investigated the association of tacrolimus concentration in CD3+ T lymphocytes (TAC[CD3]) and CD14+ monocytes (TAC[CD14]) with acute rejection after kidney transplantation. Methods: From a total of 61 samples in this case–control study, 28 samples were obtained during biopsy-proven acute rejection (rejection group), and 33 samples were obtained in the absence of rejection (control group). PBMCs were collected from both cryopreserved (retrospectively) and freshly obtained (prospectively) samples. CD3+ T lymphocytes and CD14+ monocytes were isolated from PBMCs, and their intracellular tacrolimus concentrations were measured. Results: The correlation between tacrolimus whole-blood and intracellular concentrations was poor. TAC[CD3] was significantly lower than TAC[CD14] (median 12.8 versus 81.6 pg/million cells; P
Source: Therapeutic Drug Monitoring - Category: Drugs & Pharmacology Tags: Original Article Source Type: research