Abstracts

Background: Tacrolimus, the mainstay of immunosuppression postrenal transplantation, demonstrates considerable inter-individual pharmacokinetic variability.Limited data are available for Middle Eastern populations, particularly Omanis, necessitating population-specific evaluation.Methods: A retrospective study was conducted at the Royal Hospital, Muscat (2020-2022), including 100 Omani renal transplant recipients (18 years) on tacrolimus for 6 months.Clinical, demographic, and pharmacokinetic data were analyzed using descriptive statistics.Results: Mean patient age was 37 12 years; 65% were male.Hypertension (76%), dyslipidemia (17%), and diabetes (15%) were prevalent comorbidities.e median concentration-to-dose ratio was 1.103 ng/mL/mg, with therapeutic levels reached after a mean of 59 days.At baseline, 70% were subtherapeutic, 17% supratherapeutic, and 13% therapeutic, with persistent subtherapeutic levels (70%) by the fifth assessment.Acute rejection and delayed graft function each occurred in 15%.Adverse events were common (98%), mainly electrolyte imbalance (74%), tremor/neuropathy (42%), and post-transplant diabetes (23%). Conclusion:Omani renal transplant recipients show substantial variability in tacrolimus pharmacokinetics, frequent adverse reactions, and delayed attainment of therapeutic levels.Enhanced therapeutic drug monitoring and pharmacogenomic-guided dosing may improve outcomes.