Analysis of Tacrolimus Clearance in Patients with Kidney Transplants from Romania

Rotarescu, Corina Andreea; Maruntelu, Ion; Rotarescu, Ion; Constantinescu, Alexandra-Elena; Constantinescu, Ileana

doi:10.3390/biomedicines13061501

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Analysis of Tacrolimus Clearance in Patients with Kidney Transplants from Romania

by

Corina Andreea Rotarescu

^1,2,

Ion Maruntelu

^2,*

,

Ion Rotarescu

³,

Alexandra-Elena Constantinescu

¹ and

Ileana Constantinescu

^1,2,4

¹

Department of Immunology and Transplant Immunology, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020022 Bucharest, Romania

²

Department of Immunogenetics and Virology, Fundeni Clinical Institute, 258 Fundeni Avenue, 022328 Bucharest, Romania

³

Department of Cardiovascular Surgery, Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, 258 Fundeni Avenue, 022328 Bucharest, Romania

⁴

Academy of Romanian Scientists (AOSR), 3 Ilfov Street, 030167 Bucharest, Romania

^*

Author to whom correspondence should be addressed.

Biomedicines 2025, 13(6), 1501; https://doi.org/10.3390/biomedicines13061501

Submission received: 5 February 2025 / Revised: 19 May 2025 / Accepted: 17 June 2025 / Published: 18 June 2025

(This article belongs to the Special Issue An Update on Transplantation Immunology)

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Abstract

Background/Objectives:Tacrolimus is a key immunosuppressant in kidney transplantation, but its high interindividual pharmacokinetic variability complicates dosing. This study aimed to develop a population pharmacokinetic model and identify the factors explaining variability to optimize tacrolimus therapy in Romanian kidney transplant recipients. Methods: The study included 106 kidney transplant recipients treated at Fundeni Clinical Institute (2022–2024). Tacrolimus blood levels were measured using immunoassays, while gene polymorphisms of CYP3A4, CYP3A5, and ABCB1 were identified by real-time polymerase chain reaction. Results: Patients with CYP3A4*1/*1.001 impact clearance (RSE = 11.8%), while hematocrit was a significant covariate for intercompartmental clearance (RSE = 6.14%). Conclusions: Incorporating CYP3A4*1/*1.001 genotype and hematocrit into dosing strategies can improve therapeutic drug monitoring and personalize immunosuppressive therapy.

Keywords: tacrolimus; clearance; CYP3A4; kidney transplant

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MDPI and ACS Style

Rotarescu, C.A.; Maruntelu, I.; Rotarescu, I.; Constantinescu, A.-E.; Constantinescu, I. Analysis of Tacrolimus Clearance in Patients with Kidney Transplants from Romania. Biomedicines 2025, 13, 1501. https://doi.org/10.3390/biomedicines13061501

AMA Style

Rotarescu CA, Maruntelu I, Rotarescu I, Constantinescu A-E, Constantinescu I. Analysis of Tacrolimus Clearance in Patients with Kidney Transplants from Romania. Biomedicines. 2025; 13(6):1501. https://doi.org/10.3390/biomedicines13061501

Chicago/Turabian Style

Rotarescu, Corina Andreea, Ion Maruntelu, Ion Rotarescu, Alexandra-Elena Constantinescu, and Ileana Constantinescu. 2025. "Analysis of Tacrolimus Clearance in Patients with Kidney Transplants from Romania" Biomedicines 13, no. 6: 1501. https://doi.org/10.3390/biomedicines13061501

APA Style

Rotarescu, C. A., Maruntelu, I., Rotarescu, I., Constantinescu, A.-E., & Constantinescu, I. (2025). Analysis of Tacrolimus Clearance in Patients with Kidney Transplants from Romania. Biomedicines, 13(6), 1501. https://doi.org/10.3390/biomedicines13061501

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Analysis of Tacrolimus Clearance in Patients with Kidney Transplants from Romania

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