Tacrolimus – maintenance transplant — RACP Paediatrics MCQ

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ModerateNephrologyTacrolimus – maintenance transplantRACP Paediatrics

A child is on standard maintenance immunosuppression post kidney transplant. The triple therapy regimen includes a calcineurin inhibitor, an antiproliferative agent, and a corticosteroid. What is the most commonly used calcineurin inhibitor?

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Correct answer: A — Tacrolimus

Tacrolimus is the backbone CNI in modern paediatric renal transplant protocols (superior to ciclosporin for graft survival). Standard triple therapy: tacrolimus + mycophenolate mofetil + prednisolone. Tacrolimus requires therapeutic drug monitoring (trough levels). Key side effects: nephrotoxicity, diabetes, tremor, hypertension.

Reference: RCH Melbourne – 2023 – Renal Transplant CPG; KDIGO – 2024