skip to main content

Transplant Immunosuppression — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

EasyTransplantationTransplant ImmunosuppressionESENeph

A 48-year-old man undergoes kidney transplantation from a deceased donor. Induction therapy with Basiliximab is given. He is started on Tacrolimus, Mycophenolate mofetil, and Prednisolone. On day 5, his Tacrolimus trough level is 3.2 ng/mL. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Increase Tacrolimus dose to achieve trough 8-12 ng/mL

In the early post-transplant period (first 1-3 months), Tacrolimus trough targets are typically 8-12 ng/mL (some centres use 6-10 ng/mL in the first month). A trough of 3.2 ng/mL is subtherapeutic and risks acute rejection. KDIGO 2009 transplant guideline suggests Tacrolimus as first-line CNI (2A) with initial dose achieving C0 of 10 (5-15) ng/mL. The ELITE-Symphony trial supported low-dose Tacrolimus targets of 5-10 ng/mL with superior outcomes.

Reference: KDIGO 2009 – Clinical Practice Guideline for the Care of Kidney Transplant Recipients