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Cited by 67Pharmacogenetics and Drug MetabolismRenal Transplantation Outcomes and TreatmentsTransplantation: Methods and Outcomes

The DOI matches its Crossref record; 200 of the 200 references it cites were found in a registry or an index.

Clinical Pharmacokinetics in Organ Transplant Patients

Venkataramanan, Raman, Habucky, Karen, Burckart, Gilbert J., Ptachcinski, Richard J.·1989·Clinical Pharmacokinetics
DOI 10.2165/00003088-198916030-00002
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Abstract

Diseases of the liver, kidney and heart influence the pharmacokinetics of several drugs. Organ transplantation is an accepted therapeutic option for the treatment of several disease states associated with these organs. Recently, there has been an increase in both graft and patient survival after transplantation of the liver, heart, kidney and bone marrow. Such patients normally receive a wide range of drugs, and optimisation of drug therapy requires a thorough understanding of the pharmacokinetics and pharmacodynamics of these drugs in transplant patients. However, only limited studies have been carried out to characterise drug kinetics in these situations. Available information indicates that drug kinetics cannot be considered normal in transplant patients. Drug absorption generally appears to be similar to that in healthy subjects. The plasma protein binding of drugs that primarily bind to albumin increases after transplantation, but remains lower than that observed in healthy subjects. While the binding of certain basic drugs may increase after transplantation due to an increase in the concentration of alpha 1-acid glycoprotein, a lower albumin concentration may mask this effect. Oxidative and conjugative metabolism as measured by the kinetics of antipyrine (phenazone) and paracetamol (acetaminophen) is normal, while the metabolism of steroids may be impaired. Serum creatinine does not appear to be a good indicator of the functional status of the kidney in transplant patients. It is also important to realise that there will be time-dependent changes in several kinetic parameters of drugs due to improvement in the physiological function from that associated with the disease state to that of the normal state. Individualisation and close monitoring of drug therapy is necessary in transplant patients.

Overview

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Crossref · 10.2165/00003088-198916030-00002

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Metadata

Authors
Venkataramanan, R., Habucky, K., Burckart, G. J., & Ptachcinski, R. J.
Affiliations
University of Pittsburgh (US)
ORCID
Venue
Clinical Pharmacokinetics
Publisher
Springer Science and Business Media LLC
Published
1989-03
Volume
16
Issue
3
Pages
134-161
ISSN
0312-5963 (ISSN-L)
DOI
10.2165/00003088-198916030-00002
OpenAlex
W2010559517
Cited by
67
References
200
Citations by year
2026: 1 · 2025: 4 · 2023: 2 · 2021: 2 · 2018: 1 · 2016: 2 · 2014: 1 · 2012: 3
FWCI
9.39
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Pharmacokinetics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
  • Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
Keywords
organ transplantation, pharmacokinetics, liver transplantation, kidney transplantation, heart transplantation, bone marrow transplantation, plasma protein binding, albumin, alpha-1-acid glycoprotein, drug metabolism, antipyrine, paracetamol, steroid metabolism, serum creatinine, therapeutic drug monitoring, drug absorption
MeSH terms
Azathioprine, Cyclosporins, Humans, Methylprednisolone, Pharmacokinetics, Prednisolone, Prednisone, Bone Marrow Transplantation, Heart Transplantation, Kidney Transplantation, Liver Transplantation

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