Roles of Pharmacist as a Member of the Liver Transplant team in Controlling Tacrolimus whole Blood Concentrations and Monitoring Adverse Drug Events such as Convulsion

Abstract

This study aimed to evaluate the role of the pharmacist as a member of the liver transplant team in controlling tacrolimus concentrations and the incidence of convulsions as a side effect.
Interventions of the pharmacist in the liver transplant team include the indications of dose setting, the checking of drug interactions, the monitoring of adverse effects and the instruction for patient compliance. Fifty-two patients who underwent a living-related liver transplantation were enrolled. The total number of 691 whole blood samples were collected during 2 weeks after liver transplantation and then were analyzed by microparticle enzyme immunoassay (MEIA) for tacrolimus trough concentrations.
The standard deviation of tacrolimus trough level was 5.9 before pharmacist participation, while it decreased markedly to 3.7 after pharmacist participation. In addition, the variance significantly decreased. Five of 25 patients treated with tacrolimus before pharmacist participation encountered convulsions, however, none of the 27 patients showed any signs of convulsion after pharmacist participation. There was no significant difference in the rejection before (32 %) or after (26 %) pharmacist participation.
We conclude that pharmacotherapy in the liver transplant team improved after pharmacist participation.