Transplant: Tacrolimus, What’s Your Target Range?

Hello,
My liver and first kidney were from the same donor. The liver worked fine from day one, but the kidney didn't work for the first week and a half. In fact I went back on dialysis until it came to life. It had a progressive disease that they new when they gave it to me, thinking that at 66 years old it would last me with meds. It worked well enough to keep me off dialysis but barely. Thus that it never worked from transplant, I was blessed to chosen as a priority patient. Blessed with the second kidney. Thing one works like a new Timex! For those of you who remember Timex??
Yes God has been good to me, thus the 5-7 Tac range presently.
Hope you all continue to heal? I bet turkey is a great healer!
Enjoy 😉

I am on 1.5 after 7 months liver transplant but my friend who is 12 years out is on .5 mg. She occasionally gets mild tremors and tirednes. Generally she is doing very well.
Congrats on an ideal low dose. Barbara

Im gonna message them!

Im 14 years post liver tx . After 7 years of cyclosporine and cellcept ,they took me off the cyclosporine due to nasty side effects( kidney, heart attack due to high ldl) etc, etc. Just on Cellcept 500mg-2x daily for 6 years before GI issues kicked in-(stomach ulcers,colitis, gastitis). Swithched me to Myfortic 360mg-2x daily to hopefully deal with GI issues. With that they have said that if the Myfortic doesnt work then a switch to .50mg of Tacrolimus is the next move . But after experiencing the damage that CNIs due to the body Im a little bit nervous as the cyclsporine did alot of damage. Well see!

The cyclosporine dose started at 100mg -2xdaily after liver tx then dropped to 25mg-2x daily over 6 years but by then the damage was done -kidneys,heart by pass , high potassium, . What is your GFR on .50 Tac ?

Hi all,

Just received my kidney transplant from a dear friend October 27!!!!

Tacronlimis level is now at 8.5. Started out at 2mg a day and now leveled out at 12mg a day with no side effects so far.

Here’s my motto:

Hi @bosco17 Unlike a solid organ transplant, a bone marrow transplant doesn’t require life-long anti-rejection meds after 6 months or in some cases longer. I was on varying doses for about 2.5 years to avoid graft vs host disease. The last taper was .5mg for 6+months. I’ve have been off tacro for just over a year now.

As a disclaimer, because everyone’s body chemistry is different, it’s not really productive or beneficial to compare reactions to a medication with someone else’s experience. I tolerated certain medications really well for my transplant. But a friend whom I met while going through our transplants at the same time, could not take the same meds. She reacted quite differently to the same drugs, same dosages.

That being said, I’ll give you my GFR numbers but please don’t base your potential reaction on how my body reacted to the tacro. And when it did react, my levels were very high. Not at .5mg. In all honesty, we don’t know if it was the tacro that caused the issues or combination of all the meds and having my bone marrow transplant. Tacro wasn’t the only medication I was taking. There were 8 other meds.

I love having a patient portal because I was able to take a trip down memory lane this morning and see numbers pre and post transplant (BMT)
Before the bmt, my GFR was in the 90s. The first month after bmt, it dropped to mid 70s. There are certain meds which can hold the tacro in the body for longer periods. I’d gone through a med adjustment a month later that sent my normal tacro trough of 7 soaring to 22.6. I was horribly ill for a few days. My kidneys went into failure and my GFR dropped to 27. By the next week I was back in 40s for GFR. Over the course of the next year I tapered down to .5mg tacro and GFR evened out to between 52 - 59. It’s still there after a year off tacro and we’re quite happy with that.

From my understanding, tacro, at higher dosages reduces blood flow through the kidneys which lowers the GFR. In my case, as my doctor predicted, with a drop in my tacro dosage my kidneys would improve. He was spot on. I tolerated .5mg very well with no side effects except a slight hand tremble. Nothing noteworthy. It’s a very beneficial anti-inflammatory medication.

Again, I’m not a doctor and have no knowledge of the differences between the cyclosporine dosages 25mg 2 x daily and the .5mg of tacro that’s being suggested for you.
But at .5mg it is a really low dosage and worth a try to get off the other med that’s causing issues with your health.
Because of your past history, your tacro trough should be checked often initially to keep tabs on the blood level. At this low level nothing should happen quickly that can’t be reversed if you stop taking the med. But you don’t have the luxury of not having an anti rejection drug. This small dosage might be just the trick.
You might also have your magnesium level checked. That can be depleted quickly with tacro. Magnesium glycinate is a good replacement with minimal gut issues. Do you have that done?

Hi @diovdahl Welcome to Mayo Connect! Wow, congratulations on your new kidney and what an amazing gift of life from a friend!
Thank you for sharing your beautiful and touching story with us! The motto on the coin should be put in national circulation. ☺️ Very inspirational and the best encouragement.

Dan, I want to invite you to this discussion on Snapshots of Hope~ Life on the other side of transplant. I hope you’ll post a picture of your new life after transplant…a photo that wouldn’t be possible if you’d not been given a second chance at life.
https://connect.mayoclinic.org/discussion/snapshots-of-hope-life-on-the-other-side-of-transplant/

You’ll have an extra special Thanksgiving this year. I know you’re still in the recovery stage but what are you doing to celebrate?

Hi Lori,

Thanks for the warm welcome!!

Had 50 coins made with the majority of them going to Gift of Life transplant house near Mayo in Rochester and just ordered another 100.

Skipping family Thanksgiving, and will just be my loving wife and me.

Have a wonderful Thanksgiving yourself and I’ll post on the link you sent.

Hi basco
I just had blood work this week my tacro was 2 but my liver enzymes are elevated, from what my TP team has told me they r not concerned w/the tacro at this point in my LT only the liver enzymes? So I am thinking every center is different. They r to contact me Monday about my enzymes, first time in 2yrs. that I have had them elevated. Not sure why..