Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5553197 | Biomedicine & Pharmacotherapy | 2017 | 7 Pages |
ObjectiveThis study is to analyze concentration changes of the prolonged-release and shorter-acting formulation of tacrolimus in patients with different CYP3A5 genotypes after kidney transplantation.MethodsA single-factor retrospective analysis was performed in patients underwent allogeneic kidney transplantation with postoperative administration of Advagraf or Prograf in our hospital from May 2013 to June 2014. The CYP3A5 genotypes were determined, and tacrolimus trough concentrations in whole blood were measured within 28Â days after transplantation. The rates of acute rejection rate, chronic rejection and infection were recorded and compared after one year follow-up after surgery.ResultsThe study included 106 patients administered Advagraf (45 cases) or Prograf (61 cases). The low expression genotype of CYP3A5 was detected in 40 (37.7%) patients. A higher dose of Advagraf was required to increase the tacrolimus trough concentrations within 21Â days after transplantation. Moreover, a higher dose for Advagraf than Prograf was required to increase the tacrolimus trough concentrations in low expression patients. In the low expression patients, Prograf more frequently achieved the target tacrolimus trough concentrations within seven days after transplantation (five days: 7.14% vs. 84%, PÂ =Â 0.001; seven days: 33.33% vs. 77.78%, PÂ =Â 0.001). The patient and kidney graft survival rates one year after transplantation both were 100%. The estimated glomerular filtration rate showed no significant difference between different CYP3A5 phenotypes or formulations of tacrolimus (PÂ >Â 0.05). However, the incidence of infections was higher in the Advagraf group in low expression patients (PÂ <Â 0.05).ConclusionTacrolimus of different formulations had different impact on patients with different CYP3A5 genotypes after kidney transplantation.