Tacrolimus has been accepted as the first-line drug of immunosuppressive therapy after solid organ transplantation

with the macrolide chemical structure

which is mainly used for prophylaxis of rejection in liver

kidney

heart

lung or bone marrow transplantation treatment. Based on the characteristics of narrow therapeutic window

large inter-and intra-individual variances

multiple influencing factors of drug exposure

drug monitoring is widely recommended for tacrolimus in drug instructions

clinical guidelines and literature. Drug therapy is a patient-centered and clinical-dominated multidisciplinary technical work. The information in tacrolimus drug instructions cannot cover all the issues in clinical practice. As important supplements to medical documents

clinical guidelines and expert consensus are conducive to solving clinical problems and benefiting patients． “Expert Consensus on Individual Treatment of Tacrolimusin Solid Organ Transplantation”（ hereinafter referred to as“the consensus”） drafting expert group analyzed 54 tacrolimus-related guidelines and expert consensus before 2020

and concluded that it is necessary for medical multidisciplinary cooperation to comprehensively

systematically and in-depth explain the role of tacrolimus in solid organ transplantation. The expert group not only put forward urgently needed technical support and thoroughly resolved treatment issues from clinical perspective

but clarify the drug treatment elements of concern and the pharmacist responsibility list of pharmaceutical care from pharmacological perspective

so as to strengthen the rational use of tacrolimus and improve the benefits of patients. The consensus was jointly drafted by clinical clinicians and pharmacists.The main text includes four parts: preface

clinical application

drug monitoring and clinical pharmacists

covering immunosuppressive therapy for liver

kidney

heart and lung transplantation

including clinical therapeutic targets

plasma concentration monitoring

gene polymorphism determination and drug interactions. The active participation of clinical pharmacists is helpful for individualized tacrolimus treatment. According to the experience of many organ transplantation centers in China

the consensus put forward suggestions for clinical pharmacists in organ transplantation

so as to improve the quality of pharmaceutical care and optimize the individualized tacrolimus treatment.