Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
- PMID: 29495430
- PMCID: PMC5872685
- DOI: 10.3390/nu10030267
Low Transfer of Tacrolimus and Its Metabolites into Colostrum of Graft Recipient Mothers
Abstract
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.
Keywords: HPLC; breastfeeding; drug metabolism; drug safety; transplantation.
Conflict of interest statement
The authors declare no conflict of interest.
Figures
![Figure 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5872685/bin/nutrients-10-00267-g001.gif)
![Figure 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5872685/bin/nutrients-10-00267-g002.gif)
![Figure 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/5872685/bin/nutrients-10-00267-g003.gif)
Similar articles
-
Low Content of Cyclosporine A and Its Metabolites in the Colostrum of Post-Transplant Mothers.Nutrients. 2020 Sep 4;12(9):2713. doi: 10.3390/nu12092713. Nutrients. 2020. PMID: 32899873 Free PMC article.
-
Anti-Inflammatory and Anti-Allergic Properties of Colostrum from Mothers of Full-Term and Preterm Babies: The Importance of Maternal Lactation in the First Days.Nutrients. 2023 Oct 2;15(19):4249. doi: 10.3390/nu15194249. Nutrients. 2023. PMID: 37836533 Free PMC article. Review.
-
Century Wide Changes in Macronutrient Levels in Indian Mothers' Milk: A Systematic Review.Nutrients. 2022 Mar 27;14(7):1395. doi: 10.3390/nu14071395. Nutrients. 2022. PMID: 35406008 Free PMC article. Review.
-
Tacrolimus placental transfer at delivery and neonatal exposure through breast milk.Br J Clin Pharmacol. 2013 Dec;76(6):988-96. doi: 10.1111/bcp.12122. Br J Clin Pharmacol. 2013. PMID: 23528073 Free PMC article.
-
Breastfeeding and tacrolimus: serial monitoring in breast-fed and bottle-fed infants.Clin J Am Soc Nephrol. 2013 Apr;8(4):563-7. doi: 10.2215/CJN.06400612. Epub 2013 Jan 24. Clin J Am Soc Nephrol. 2013. PMID: 23349333 Free PMC article.
Cited by
-
Drugs in Human Milk Part 1: Practical and Analytical Considerations in Measuring Drugs and Metabolites in Human Milk.Clin Pharmacokinet. 2024 May;63(5):561-588. doi: 10.1007/s40262-024-01374-3. Epub 2024 May 15. Clin Pharmacokinet. 2024. PMID: 38748090 Review.
-
British Society for Rheumatology guideline on prescribing drugs in pregnancy and breastfeeding: immunomodulatory anti-rheumatic drugs and corticosteroids.Rheumatology (Oxford). 2023 Apr 3;62(4):e48-e88. doi: 10.1093/rheumatology/keac551. Rheumatology (Oxford). 2023. PMID: 36318966 Free PMC article. No abstract available.
-
Breastfeeding and Medication Use in Kidney Disease.Adv Chronic Kidney Dis. 2020 Nov;27(6):516-524. doi: 10.1053/j.ackd.2020.05.007. Epub 2020 May 11. Adv Chronic Kidney Dis. 2020. PMID: 33328068 Free PMC article. Review.
-
Low Content of Cyclosporine A and Its Metabolites in the Colostrum of Post-Transplant Mothers.Nutrients. 2020 Sep 4;12(9):2713. doi: 10.3390/nu12092713. Nutrients. 2020. PMID: 32899873 Free PMC article.
References
-
- Gartner L.M., Morton J., Lawrence R.A., Naylor A.J., O’Hare D., Schanler R.J., Eidelman A.I. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496–506. - PubMed
-
- ESPGHAN Committee on Nutrition. Agostoni C., Braegger C., Decsi T., Kolacek S., Koletzko B., Michaelsen K.F., Mihatsch W., Moreno L.A., Puntis J., et al. Breast-feeding: A commentary by the ESPGHAN Committee on Nutrition. J. Pediatr. Gastroenterol. Nutr. 2009;49:112–125. doi: 10.1097/MPG.0b013e31819f1e05. - DOI - PubMed
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Miscellaneous