What tacrolimus trough levels are targeted after kidney transplant?

Early (month 1–3): 10–15 ng/mL. Month 3–6: 8–12 ng/mL. Month 6–12: 7–10 ng/mL. After 1 year: 5–8 ng/mL. Higher end of range for high immunologic risk (young patients, HLA mismatch, re-transplant, delayed graft function). Levels 15 ng/mL risk nephrotoxicity and PTDM.

How does tacrolimus cause post-transplant diabetes mellitus?

Tacrolimus inhibits calcineurin in pancreatic beta cells, reducing insulin secretion. PTDM risk: 10–30% in kidney transplant recipients on tacrolimus. Risk factors: older age, obesity, Hispanic/African American ethnicity, steroid use, HCV infection, CMV, tacrolimus levels >10 ng/mL. Converting to cyclosporine or everolimus reduces PTDM risk.

Tacrolimus Whole Blood Trough Level Targets

Interpret tacrolimus trough levels by transplant type, time post-transplant, and risk stratification to optimize immunosuppression while minimizing nephrotoxicity and opportunistic infection risk.

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Tacrolimus Whole Blood Trough Level Targets

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Frequently Asked Questions

What tacrolimus trough levels are targeted after kidney transplant?

How does tacrolimus cause post-transplant diabetes mellitus?