Abstract
Introduction: Although the association between CYP3A5 gene polymorphism and tacrolimus dosing requirements was well established, the impact on how CYP3A5 genotype affects the acute rejection and long-term renal function in patients who received kidney transplants and were treated with tacrolimus remained controversial. Design: Sixty-seven Chinese patients with kidney transplants receiving de novo tacrolimus-based immunosuppressive therapy with known CYP3A5 genotype were divided into 2 groups. Those with at least 1 CYP3A5*1 allele were CYP3A5 expressers while homozygotes for the mutant allele CYP3A5*3 were nonexpressers. Instead of trough level, our center used abbreviated area under the curve for tacrolimus monitoring. Primary outcome was the long-term renal function between both groups while secondary outcomes included the weight-adjusted daily tacrolimus dose, graft survival, incidence of biopsy-proven acute rejection (BPAR), opportunistic infection, and cancer. Results: Thirty-five (52.2%) patients were CYP3A5 expressers while 32 were nonexpressers. Mean daily tacrolimus dose in the CYP3A5 expressers and nonexpressers was 0.08 (0.03) and 0.05 (0.02) mg/kg, respectively (P< .01). Starting from 1-month posttransplant, the renal function was comparable between both groups, which persisted up to 10-year. Ten patients experienced BPAR rejection and there was no significant difference in the rejection-free survival between both groups (P= .87). There was also no significant difference in the death-censored graft survival between both groups (P= .86). Finally, the incidence of opportunistic infection and posttransplant cancer was similar between them. Discussion: There was no significant difference in renal function, graft survival, and acute rejection between CYP3A5 expressers and nonexpressers.
Original language | English |
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Article number | 1526924820933823 |
Pages (from-to) | 249-253 |
Number of pages | 5 |
Journal | Progress in Transplantation |
Volume | 30 |
Issue number | 3 |
DOIs | |
Publication status | Published - Sept 2020 |
Keywords
- kidney transplant
- pharmacogenetics
- tacrolimus
- ACUTE REJECTION
- CALCINEURIN INHIBITORS
- DOSE REQUIREMENTS
- PHARMACOKINETICS
- IMPACT
- 6986A-GREATER-THAN-G
- PHARMACOGENETICS
- PHARMACODYNAMICS
- VARIANT
- TRIAL