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Case Reports
. 2013 Jan;23(1):71-3.
doi: 10.4103/0971-4065.107216.

Combined approach with therapeutic drug monitoring and pharmacogenomics in renal transplant recipients

S Manvizhi  1 , B S Mathew, D H Fleming, G Basu, G T John
Affiliations
Case Reports

Combined approach with therapeutic drug monitoring and pharmacogenomics in renal transplant recipients

S Manvizhi et al. Indian J Nephrol. 2013 Jan.

Abstract

In patients undergoing renal transplantation, dose individualization for tacrolimus is routinely achieved with therapeutic drug monitoring (TDM). The patient started on 5.5 mg/day of tacrolimus had a significantly elevated tacrolimus trough concentration. The tacrolimus dose was regularly reduced following TDM at many time periods in the post transplant period but the tacrolimus concentration was consistently elevated. Genomic analysis done after four years revealed mutations in the genes encoding for CYP3A5 and MDR1 (2677G > T). Pharmacogenomics alongside TDM, will soon emerge as the backbone of dose individualization. But for genomics to be beneficial, it should be advocated in the pre-transplant or early post transplant period.

Keywords: Drug monitoring; polymorphism; tacrolimus.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Tacrolimus dose (mg/kg) and trough measurements (ng/mL) over time
See this image and copyright information in PMC

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