ArticleWorld journal of transplantation2025
Impact of cytochrome P450 3A5 expression on clinical outcomes in renal transplant recipients receiving tacrolimus-based immunosuppression.
Article in World journal of transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- ABCC2 rs2273697 is an independent determinant of tacrolimus intra-patient variability during the first year after kidney transplantation.International journal of clinical pharmacy · 2026Article
- Rejection-Focused Precision Medicine in Kidney Transplantation: Biology, Biomarkers, and Artificial Intelligence.Life (Basel, Switzerland) · 2026Review
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16 authors.
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Abstract
backgroundKidney transplantation is an effective renal replacement therapy for improving survival and quality of life in chronic kidney disease patients. Kidney transplant recipients need lifelong immunosuppression to prevent rejection and allograft dysfunction. Tacrolimus, a calcineurin inhibitor, is metabolized differently based on cytochrome P450 3A (CYP3A)5 genetic variations and this impacts the graft outcome.
aimTo examine the clinical outcomes in kidney transplant recipients affected by the variable metabolism of tacrolimus due to the CYP3A5 genetic variation, emphasizing personalized immunosuppression strategies to optimize efficacy, minimize toxicity, and enhance long-term graft survival.
methodsA retrospective study was conducted at a tertiary care center in Central India on 95 kidney transplant recipients. Patient demographics, medical history, CYP3A5 polymorphism, post-transplant investigations, graft biopsy results, preexisting comorbidities, history of post-kidney transplant infections, and new onset diabetes after transplantation (NODAT) was collected. Tacrolimus was initiated at 0.1 mg/kg/day for CYP3A5 expressors and 0.05 mg/kg/day for non-expressors, with dose adjustments to maintain target C0 levels of 7-10 ng/mL for first 6 months and 5-7 ng/mL from 6 months to 12 months posttransplant. Patients were followed regularly for one year for glomerular filtration rate (GFR), creatinine, and the tacrolimus trough concentration (ng/mL)/daily tacrolimus dose (mg/kg/day) ratio (C/D). A
resultsKidney transplant recipients were classified as expressors (CYP3A51 carriers,
conclusionCYP3A5 expressors require higher tacrolimus doses to maintain therapeutic levels as compared to non-expressors. BPAR was higher in expressors but the difference was not significant. Graft function, infection rate, and NODAT were comparable irrespective of CYP3A5 expression status, emphasizing the importance of pretransplant CYP3A5 genotyping and therapeutic drug monitoring to guide tacrolimus dosing for individualized immunosuppressive management.
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