MARC details
| 000 -LEADER |
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| fixed length control field |
03758nam a22006017a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
130807s20132013 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
0041-1337 |
| 040 ## - CATALOGING SOURCE |
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| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| PMID |
23274970 |
| 245 ## - TITLE STATEMENT |
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| Title |
Interpreting tacrolimus concentrations during pregnancy and postpartum. [Review] |
| 251 ## - Source |
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| Source |
Transplantation. 95(7):908-15, 2013 Apr 15. |
| 252 ## - Abbreviated Source |
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| Abbreviated source |
Transplantation. 95(7):908-15, 2013 Apr 15. |
| 253 ## - Journal Name |
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| Journal name |
Transplantation |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Year |
2013 |
| 266 ## - Date added to catalog |
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| Date added to catalog |
2013-09-17 |
| 501 ## - WITH NOTE |
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| Local holdings |
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1999 - 2006 |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Pregnancy after solid organ transplantation, although considered high risk for maternal, fetal, and neonatal complications, has been quite successful. Tacrolimus pharmacokinetic changes during pregnancy make interpretation of whole blood trough concentrations particularly challenging. There are multiple factors that can increase the fraction of unbound tacrolimus, including but not limited to low albumin concentration and low red blood cell count. The clinical titration of dosage to maintain whole blood tacrolimus trough concentrations in the usual therapeutic range can lead to elevated unbound concentrations and possibly toxicity in pregnant women with anemia and hypoalbuminemia. Measurement of plasma or unbound tacrolimus concentrations for pregnant women might better reflect the active form of the drug, although these are technically challenging and often unavailable in usual clinical practice. Tacrolimus crosses the placenta with in utero exposure being approximately 71% of maternal blood concentrations. The lower fetal blood concentrations are likely due to active efflux transport of tacrolimus from the fetus toward the mother by placental P-glycoprotein. To date, tacrolimus has not been linked to congenital malformations but can cause reversible nephrotoxicity and hyperkalemia in the newborn. In contrast, very small amounts of tacrolimus are excreted in the breast milk and are unlikely to elicit adverse effects in the nursing infant. |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Drug Monitoring |
| 9 (RLIN) |
562 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
*Immunosuppressive Agents/bl [Blood] |
| 9 (RLIN) |
563 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
*Organ Transplantation |
| 9 (RLIN) |
564 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Postpartum Period/bl [Blood] |
| 9 (RLIN) |
565 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
*Pregnancy Complications/pc [Prevention & Control] |
| 9 (RLIN) |
566 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Tacrolimus/bl [Blood] |
| 9 (RLIN) |
567 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Breast Feeding |
| 9 (RLIN) |
568 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Female |
| 9 (RLIN) |
7 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Fetal Blood/me [Metabolism] |
| 9 (RLIN) |
569 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Fetus/de [Drug Effects] |
| 9 (RLIN) |
570 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Humans |
| 9 (RLIN) |
11 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Immunosuppressive Agents/ae [Adverse Effects] |
| 9 (RLIN) |
571 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Immunosuppressive Agents/pk [Pharmacokinetics] |
| 9 (RLIN) |
572 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Maternal Exposure |
| 9 (RLIN) |
573 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Maternal-Fetal Exchange |
| 9 (RLIN) |
574 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Milk, Human/me [Metabolism] |
| 9 (RLIN) |
575 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Placental Circulation |
| 9 (RLIN) |
576 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Pregnancy Complications/bl [Blood] |
| 9 (RLIN) |
577 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Pregnancy Complications/im [Immunology] |
| 9 (RLIN) |
578 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
Pregnancy |
| 9 (RLIN) |
243 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Protein Binding |
| 9 (RLIN) |
579 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Risk Assessment |
| 9 (RLIN) |
514 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Risk Factors |
| 9 (RLIN) |
311 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Tacrolimus/ae [Adverse Effects] |
| 9 (RLIN) |
580 |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Tacrolimus/pk [Pharmacokinetics] |
| 9 (RLIN) |
581 |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Health Research Institute |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Journal Article |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Research Support, N.I.H., Extramural |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Review |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Miodovnik, Menachem |
| 9 (RLIN) |
560 |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Local Authors |
Umans, Jason G |
| 9 (RLIN) |
561 |
| 790 ## - Authors |
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| All authors |
Davis CL, Easterling TR, Hays K, Hebert MF, Miodovnik M, Shen DD, Thummel KE, Umans JG, Zheng S |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="http://dx.doi.org/10.1097/TP.0b013e318278d367">http://dx.doi.org/10.1097/TP.0b013e318278d367</a> |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
|---|
| Koha item type |
Journal Article |
| Item type description |
Journal article |
| Source of classification or shelving scheme |
Other/Generic Classification Scheme |
