Abstract:

Objective To explicit the characteristics and influencing factors of tacrolimus blood concentration in early postoperative stage of liver transplantation recipients, and to provide a basis for individualized treatment. Methods Whole blood trough concentrations of tacrolimus were analyzed in 14 days post livertransplantation in 87 recipients. Using C0/D/W as the dependent variable, the recipient demographic factors, liverand kidney function, CYP3A5 genotype and combined therapy with calcium channel blockers were considered as independent variables, the influencing factors of tacrolimus blood concentration were analyzed by multivariate stepwise regression method. Results Variability of tacrolimus blood concentration was significant and 47.1% of the recipients could not reach the target range in the first 14 days post transplantation. Recipient body weight, hematocrit, CYP3A5 genotype, albumin, combined use of calcium channel blockers, alanine aminotransferase were factors influencing the blood concentration of tacrolimus in the early postoperative period. Conclusion The blood concentration of tacrolimus in the early stage post liver transplantation is affected by many factors. The clinical pharmacist should work closely with the clinical doctor to comprehensively consider various influencing factors and formulate a more reasonable individualized treatment plan.

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摘要：

目的 探讨肝移植受者术后早期他克莫司（tacrolimus，Tac）血药浓度的特点及影响因素，为肝移植受者的个体化治疗提供依据。方法 选取本中心肝移植受者 87 例，对肝移植受者术后 14 d 内 Tac 的血药浓度进行分析，并以 C0/D/W 为因变量，受者基本资料、肝肾功能、CYP3A5 基因型和合并使用钙通 道阻滞药等为自变量，用多元逐步回归方法探讨 Tac 血药浓度的影响因素。结果 术后早期 Tac 的波动范 围较大，47.1% 的受者 Tac 血药浓度不能在术后 14 d 内达到目标范围，受者体重、红细胞比容、CYP3A5 基 因型、白蛋白、合并使用钙通道阻滞药、丙氨酸转氨酶（alanine aminotransferase，ALT）对术后早期 Tac 的 血药浓度有影响。结论 肝移植术后早期 Tac 血药浓度受多种因素的影响，临床药师应与医生密切合作， 综合考虑各种影响因素，制定更加合理的个体化治疗方案。

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