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.

Objective The published literature on population pharmacokinetic modeling of oral Tacrolimusfor adult liver transplantation based on CYP3A5 genotype was searched, and the self-built model and published model were fitted to select the appropriate population pharmacokinetic model for the initial measurement and individualized treatment of patients. Methods The relevant models were screened out by searching PubMed， Scopus and Web of Science. The data were validated by normalized prediction distribution errors（NPDE）. Results A total number of 40 adult patients with liver transplantation were collected in our center. One one-compartment model， one two-compartment model were retrieved, and one two-compartment self-built model was developed. NPDE showed that the recommended dose for both donors and recipients is 1.48 ~ 1.93 mg for non-carriers of CYP3A5*1, 2.1 ~ 2.35 mg for either donors or recipients who carry CYP3A5*1, and 2.7 ~ 2.9 mg for both donors and recipients who carry CYP3A5*1. Conclusion Donor-recipient CYP3A5*1 genotypes should be included in the model for personalized medicine， and prospective studies should be carried out to gradually improve the Tacrolimus populationpharmacokinetic model of adult liver transplantation patients in our center.

Objective To investigate the effect of wuzhi capsule combined with CYP3A5*3 genetic polymorphism on the tacrolimus blood trough concentration （C0） of renal transplant recipients in the early post transplant stage. Methods CYP3A5*3 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP）. Tacrolimus C0 was tested using chemiluminescence immunoassay （CMIA）. The effect of both the daily dose （D） of wuzhi capsule and CYP3A5*3 genotype on the tacrolimusdose-adjusted trough concentration （C0/D） was evaluated in the early post transplant stage. Results Among all of the different wuzhi capsule groups （0，22.5 and 45 mg）， tacrolimus C0/D of CYP3A5 expressers （*1/*1+*1/*3） wassignificantly lower than that of non-expressers （*3/*3） on day 3，7 and 14 after renal transplantation （P ＜ 0.05）. InCYP3A5 expressers on day 3，7 and 14， there were significant differences of tacrolimus C0/D among different wuzhi capluse groups （0，22.5 and 45 mg）. However， on day 14， tacrolimus C0/D with 67.5 mg wuzhi capsule group was significantly lower than those of both 22.5 mg and 45 mg groups （P ＞ 0.05）， and tacrolimus C0/D with 45 mg groupwas significantly lower than that of 22.5 mg group （P ＞ 0.05）. Conclusion For renal transplant recipients with CYP3A5 express， wuzhi capsule could be used to increase the blood concentration of tacrolimus and reduce its costs in the early stage after transplantation.