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- Title
Identification of Factors Affecting Tacrolimus Level and 5-Year Clinical Outcome in Kidney Transplant Patients.
- Authors
Kim, In-Wha; Noh, Hyejin; Ji, Eunhee; Han, Nayoung; Hong, Su Hyun; Ha, Jongwon; Burckart, Gilbert J.; Oh, Jung Mi
- Abstract
The purpose of this study was to identify and characterize the association of various clinical variables and CYP3A5 genotypes with the pharmacokinetics of tacrolimus and outcome over 1-5 years in kidney transplantation patients in Korea. A total of 129 recipients (aged 18-65 years) administered tacrolimus were genotyped for CYP3A5 (6986 A> G in intron 3; rs776746). Clinical covariates and trough levels, doses and dose-adjusted trough levels of tacrolimus, as well as complications during the 1-5 years after transplantation, were analysed. A linear mixed model was used to investigate potential factors affecting the trough levels, doses and dose-adjusted levels of tacrolimus. We identified factors affecting chronic allograft nephropathy ( CAN) and tacrolimus-related complications. After adjusting for sex, body-weight and doses of corticosteroids and mycophenolate mofetil, we noted that CYP3A5 genotypes had the most profound effect on the dose and dose-adjusted trough levels of tacrolimus 1-5 years after transplantation ( p < 0.001). Trough levels of tacrolimus were associated with post-transplantation hyperlipidaemia ( p < 0.05), and estimated glomerular filtration rate was associated with CAN ( p < 0.05). Therefore, the CYP3A5 genotype is a variable marker for tacrolimus dose requirement, and the trough level of tacrolimus should be controlled to minimize post-transplant hyperlipidaemia to achieve optimum outcome.
- Subjects
KOREA; TACROLIMUS; KIDNEY transplant patients; HEALTH outcome assessment; PHARMACOKINETICS; COMPLICATIONS from organ transplantation
- Publication
Basic & Clinical Pharmacology & Toxicology, 2012, Vol 111, Issue 4, p217
- ISSN
1742-7835
- Publication type
Article
- DOI
10.1111/j.1742-7843.2012.00892.x