Impact of CYP3A5 genomic variances on clinical outcomes among African American kidney transplant recipients.

Little is known about the impact of CYP3A5 polymorphisms on transplantation outcomes among African-American (AA) kidney transplant recipients. To assess this issue, clinical outcomes were compared between AA CYP3A5*1 expressers versus non-expressers. This retrospective cohort study analyzed AA kidney transplant recipients. 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 CYP3A5*1 expressers compared to non-expressers, the incidence of BPAR was significantly higher in the first 6 months (13% versus 0%; p=0.016) compared to 24 months (13% versus 7%; p = 0.521). Tacrolimus total daily dose at first therapeutic level was significantly higher in CYP3A5*1 expressers (12 mg/day) compared to non-expressers (8 mg/day; p<0.001). Compared to CYP3A5*1 non-expressers, DGF incidence was significantly higher among CYP3A5*1 expressers (27.6% versus 6.7%; p = 0.006). By contrast, median GFR was significantly higher in CYP3A5*1 expressers compared to non-expressers (54.5 ml/min versus 50.0 ml/min; p = 0.003) at 24 months. The findings from this retrospective study suggest that AAs with CYP3A5*1 expression require 50% more tacrolimus, and have an increased incidence of DGF and acute rejection. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Citation

Tomefa E Asempa, Lorita M Rebellato, Suzanne Hudson, Kimberly Briley, Angela Q Maldonado. Impact of CYP3A5 genomic variances on clinical outcomes among African American kidney transplant recipients. Clinical transplantation. 2017 Nov 21

PMID: 29161757

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