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Hello Friends, 

I had my transplant in OCT 2012.  Everything was good til last 2 quarterly blood work. 

Somehow TACROLIMUS LEVEL going down <2.0 ng/mL  And Creatinine going up 1.27 mg/dL.  Any idea why this is happening ? is this early sign of rejection ? 



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  • Update :  Tacrolimus level same after increasing dose from 2 mg/day to 4 mg/day. Now I m taking 6mg/day. But Createtine went down little bit 1.22 mg/dL. 

    Not sure if this rejection or something else.   Will do one more test after 1 week.  

    • Hello Amit!


      I am about 3.5 months out from my liver transplant and have had problems with my Tacrolymus readings recentl. Mine has been "jumping around" due to my not undertanding the importance of timing between taking my meds and getting labs. I have found that my reading change a lot when timing of doses and getting labs changes even a little.


      I take 1mG capsules and once forgot and took a single capsukle before getting my labs - this caused a jump from previous week of 5.6 nG/mL to 15.8 nG/mL.

    • Given the range of your creatinine, This does not appear to be a rejection. Are you taking it with or without food? Are you avoiding Grapefruit, Starfruit Tamarind, and Pomegranate? These can speed up the metabolism of Tacrolimus leading to initial highs followed by low readings at the 12 hr mark when you test your blood. Please keep us posted (It's how we all learn,) of your progress and I hope you receive answers soon.

  • Creatinine  1.27 is not bad.  what is your usual creat level?

    My friends creat level is always 1.3 for the past many years

    swelling and urine protein are main symptoms of rejection


    • It is always less than 1 .... I will do one more  test on Friday after increasing prograf dosage .... lets see how it goes ..

  • My doctors increased prograf dose from 2 mg/day to 4 mg/day  ..they will test again next week to see prograf level. 

  • Could only guess.  Did you get your Tac done at 11.5 or 12 hour post dose?

    My creatinine fluctuates a fair amount, usually a tad higher than yours.  Ask the team, see how they interpret the data.

    • Yes it was around 12 hour of gap. I just had test again and waiting for results. I will keep you updated. 

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