الفهرس 
صفحة العنوانOnly 14 pages are availabe for public view
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Abstract
ckgrounrl: Living Donor liver transplantation (LDLT) has become treatment of
choice for patients with end stage liver disease (ESLD) in Egypt, owing to the lack
f other therapies and inapplicability of cadaver transplantation. It has been reported
that ESLD due to hepatitis C virus (HCV) and Hepatocellular carcinoma (HCC) are
the most common indications for liver transplant in Egypt with prevalence of 64%
and 26% respectively (Amer and Marwan, 2016; Yosry et al., 2009). The survival
of the liver transplant recipients depends directly on the convenient use of
unmunosuppressive regimen, which currently centered on Tacrolimus (Chen et al.,
2017). Regardless of its success in guaranteeing graft survival, therapeutic use of
acrolimus is complicated by its narrow therapeutic index and large
pbannacokinetic variability both between and within patients (Andreu et al., 2017).
In addition, dose-normalized whole blood concentrations tend to increase during the
first months after living donor liver transplantation. Therefore, individual dosing of
tacrolimus is a major clinical challenge. Population pharmacokinetic modeling is the
tudy of pharmacokinetic variability in the population. One goal of such studies is
to improve individual drug treatment by identifying relationships between
pharmacokinetic parameters and patient characteristics.
’MS: The Objectives of this research are to determine to what extent the
pbannacokinetic variability of tacrolimus in adult liver transplant recipients still
ists, even after optimization of all the known pre-transplant classic eo-variables.
And, to develop a population pharmacokinetic model for the adult Egyptian liver
transplant recipient that can be practically applied to adjust the dose of Tacrolimus
on an individual basis, along with providing guidelines for dose adjustment in
time-varying covariables, whose dose adjustment is extremely