In the unstable clinical phase, whole body clearance of tacrolimus and its metabolites is influenced by a diversity of factors, among which severe cholestasis, anemia and hypo‐albuminemia may all substantially alter the clearance 75. Cholestasis reflects hepatic dysfunction, which decreases the metabolism and transport of tacrolimus into the bile, resulting in a reduced clearance of tacrolimus. Anemia and hypo‐albuminemia increase the unbound concentrations, which could augment the uptake of tacrolimus into the liver resulting in a higher clearance. This may explain the finding that patients with a low hematocrit (