Adverse Effects of Tacrolimus in Renal Transplant Patients from Living Donors

Nailya      Bulatova; Al-Motassem      Yousef; Ghada      Al-Khayyat; Hisham      Qosa

Abstract

Introduction: The main objectives of this study were to estimate the prevalence of and the risk factors for the adverse effects of tacrolimus-based immunosuppression in patients who obtained renal transplant from living donors. Methods: A multicenter cross-sectional observational study in 154 kidney transplant patients who received grafts from living donors. Results: Large proportion of patients had hypertension (83%) and hyperlipidemia (53%); 27% had posttransplant diabetes mellitus. Patients had on average two chronic diseases. Tremor was present in 40%, neurologic toxicity in 45%, and anemia in 51.5% of patients. The average number of adverse effects was 3.52 ± 1.57. In multivariate analysis some adverse effects were related to tacrolimus concentration, duration of treatment, number of medications or medical problems. In linear regression analysis correlation was found, among the others, between diastolic blood pressure and tacrolimus concentration, and inverse correlation between erythrocyte count and duration of treatment. Conclusion: There is a significant prevalence of tacrolimus adverse effects and supratherapeutic TAC blood concentrations in Jordanian renal transplant patients in spite of using low TAC doses and overall adequate renal function.

Keywords: Tacrolimus, adverse effects, living donors, kidney transplant, immunosuppression, hypertension, hyperlipidemia, neurologic toxicity, ADRs, HTN, MMF, CrCl, FPG, PTDM, ALT, OHA, LDL-C, HDL-C, LLAs, CAD, anemia, Diabetes Mellitus, BMI, Malignancy