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Impact of CYP 3A5 genomic variances on clinical outcomes among African American kidney transplant recipients
Author(s) -
Asempa Tomefa E.,
Rebellato Lorita M.,
Hudson Suzanne,
Briley Kimberly,
Maldonado Angela Q.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13162
Subject(s) - tacrolimus , medicine , incidence (geometry) , kidney transplant , renal function , retrospective cohort study , dosing , kidney transplantation , urology , kidney , transplantation , cohort , physics , optics
Little is known about the impact of CYP 3A5 polymorphisms on transplantation outcomes among African American ( AA ) kidney transplant recipients (KTRs). To assess this issue, clinical outcomes were compared between AA CYP 3A5*1 expressers and nonexpressers. This retrospective cohort study analyzed AA KTRs. Biopsy‐proven acute rejection ( BPAR ), delayed graft function ( DGF ), glomerular filtration rate ( GFR ), infections, and tacrolimus dosing requirements were examined in 106 immunologically high‐risk AA kidney transplant patients over a 2‐year follow‐up period. In CYP 3A5*1 expressers compared to nonexpressers, the incidence of BPAR was significantly higher in the first 6 months (13% vs 0%; P = .016) compared to 24 months (13% vs 7%; P = .521). Tacrolimus total daily dose at first therapeutic level was significantly higher in CYP 3A5*1 expressers (12 mg/day) compared to nonexpressers (8 mg/day; P < .001). Compared to CYP 3A5*1 nonexpressers, DGF incidence was significantly higher among CYP 3A5*1 expressers (27.6% vs 6.7%; P = .006). By contrast, median GFR was significantly higher in CYP 3A5*1 expressers compared to nonexpressers (54.5 mL/min vs 50.0 mL/min; P = .003) at 24 months. The findings from this retrospective study suggest that AA s with CYP 3A5*1 expression require 50% more tacrolimus and have an increased incidence of DGF and acute rejection.