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Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers

Currently, the majority of neonates born to organ recipient mothers on chronic immunosuppressive therapy are formula fed. However, over the past few years, evidence has grown, suggesting that breastfeeding might be possible and beneficial. We designed a study assessing the transfer of tacrolimus int...

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Autores principales: Kociszewska-Najman, Bozena, Mazanowska, Natalia, Pietrzak, Bronislawa, Paczek, Leszek, Szpotanska-Sikorska, Monika, Schreiber-Zamora, Joanna, Hryniewiecka, Ewa, Zochowska, Dorota, Samborowska, Emilia, Dadlez, Michal, Wielgos, Miroslaw
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872685/
https://www.ncbi.nlm.nih.gov/pubmed/29495430
http://dx.doi.org/10.3390/nu10030267
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author Kociszewska-Najman, Bozena
Mazanowska, Natalia
Pietrzak, Bronislawa
Paczek, Leszek
Szpotanska-Sikorska, Monika
Schreiber-Zamora, Joanna
Hryniewiecka, Ewa
Zochowska, Dorota
Samborowska, Emilia
Dadlez, Michal
Wielgos, Miroslaw
author_facet Kociszewska-Najman, Bozena
Mazanowska, Natalia
Pietrzak, Bronislawa
Paczek, Leszek
Szpotanska-Sikorska, Monika
Schreiber-Zamora, Joanna
Hryniewiecka, Ewa
Zochowska, Dorota
Samborowska, Emilia
Dadlez, Michal
Wielgos, Miroslaw
author_sort Kociszewska-Najman, Bozena
collection PubMed
description Currently, the majority of neonates born to organ recipient mothers on chronic immunosuppressive therapy are formula fed. However, over the past few years, evidence has grown, suggesting that breastfeeding might be possible and beneficial. We designed a study assessing the transfer of tacrolimus into the colostrum of posttransplant mothers. We assessed the amount of tacrolimus and its metabolites, M-1 and M-3, that would be ingested by the breastfed neonates. Concentrations of tacrolimus and its metabolites were measured in colostrum from 14 posttransplant mothers as well as in venous cord blood and venous blood of the neonates. Test material analysis was performed by liquid chromatography coupled with mass spectrometry (LC/MS). The amount of ingested formula was registered, which allowed for estimation of the amount of tacrolimus and its metabolites that would be ingested by breastfed infants. The mean amount of tacrolimus that would be ingested by the neonates in maternal milk was 151.4 ng/kg/24 h (standard deviation SD ± 74.39); metabolite M-1: 23.80 ng/kg/24 h (SD ± 14.53); and metabolite M-3: 13.25 ng/kg/24 h (SD ± 9.05). The peak level of tacrolimus and metabolite M-1 in colostrum was noted 8 h after an oral dose (3.219 ng/mL SD ± 2.22 and 0.56 ng/mL SD ± 0.60, respectively) and metabolite M-3 after 6 h (0.29 ng/mL SD ± 0.22). Low concentrations of tacrolimus and its metabolites, M-1 and M-3, in colostrum show that neonates will ingest trace amounts of the drug. Further studies are required to fully assess the safety of breastfeeding by posttransplant mothers.
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spelling pubmed-58726852018-03-30 Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers Kociszewska-Najman, Bozena Mazanowska, Natalia Pietrzak, Bronislawa Paczek, Leszek Szpotanska-Sikorska, Monika Schreiber-Zamora, Joanna Hryniewiecka, Ewa Zochowska, Dorota Samborowska, Emilia Dadlez, Michal Wielgos, Miroslaw Nutrients Article Currently, the majority of neonates born to organ recipient mothers on chronic immunosuppressive therapy are formula fed. However, over the past few years, evidence has grown, suggesting that breastfeeding might be possible and beneficial. We designed a study assessing the transfer of tacrolimus into the colostrum of posttransplant mothers. We assessed the amount of tacrolimus and its metabolites, M-1 and M-3, that would be ingested by the breastfed neonates. Concentrations of tacrolimus and its metabolites were measured in colostrum from 14 posttransplant mothers as well as in venous cord blood and venous blood of the neonates. Test material analysis was performed by liquid chromatography coupled with mass spectrometry (LC/MS). The amount of ingested formula was registered, which allowed for estimation of the amount of tacrolimus and its metabolites that would be ingested by breastfed infants. The mean amount of tacrolimus that would be ingested by the neonates in maternal milk was 151.4 ng/kg/24 h (standard deviation SD ± 74.39); metabolite M-1: 23.80 ng/kg/24 h (SD ± 14.53); and metabolite M-3: 13.25 ng/kg/24 h (SD ± 9.05). The peak level of tacrolimus and metabolite M-1 in colostrum was noted 8 h after an oral dose (3.219 ng/mL SD ± 2.22 and 0.56 ng/mL SD ± 0.60, respectively) and metabolite M-3 after 6 h (0.29 ng/mL SD ± 0.22). Low concentrations of tacrolimus and its metabolites, M-1 and M-3, in colostrum show that neonates will ingest trace amounts of the drug. Further studies are required to fully assess the safety of breastfeeding by posttransplant mothers. MDPI 2018-02-27 /pmc/articles/PMC5872685/ /pubmed/29495430 http://dx.doi.org/10.3390/nu10030267 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kociszewska-Najman, Bozena
Mazanowska, Natalia
Pietrzak, Bronislawa
Paczek, Leszek
Szpotanska-Sikorska, Monika
Schreiber-Zamora, Joanna
Hryniewiecka, Ewa
Zochowska, Dorota
Samborowska, Emilia
Dadlez, Michal
Wielgos, Miroslaw
Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
title Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
title_full Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
title_fullStr Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
title_full_unstemmed Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
title_short Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
title_sort low transfer of tacrolimus and its metabolites into colostrum of graft recipient mothers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872685/
https://www.ncbi.nlm.nih.gov/pubmed/29495430
http://dx.doi.org/10.3390/nu10030267
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