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. 2025 May 2;15(5):185.
doi: 10.3390/jpm15050185.

Prevalence of Actionable Exposures to Pharmacogenetic Medications Among Solid Organ Transplant Recipients in a Population-Scale Biobank

Alaa Radwan  1   2 , Kimberly M Deininger  1 , Amrut V Ambardekar  3 , Heather D Anderson  2   4 , Nicholas Rafaels  2 , Laura M Saba  1 , The Colorado Center For Personalized Medicine  2 , Christina L Aquilante  1   2
Affiliations

Prevalence of Actionable Exposures to Pharmacogenetic Medications Among Solid Organ Transplant Recipients in a Population-Scale Biobank

Alaa Radwan et al. J Pers Med. .

Abstract

Background/Objectives: Solid organ transplant (SOT) recipients are exposed to multiple medications, many of which have pharmacogenetic (PGx) prescribing recommendations. This study leveraged data from a population-scale biobank and an enterprise data warehouse to determine the prevalence of actionable exposures to PGx medications among kidney, heart, and lung transplant recipients during the first six months post-transplant. Methods: We conducted a retrospective analysis of adult SOT patients with genetic data available from the Colorado Center for Personalized Medicine (CCPM) biobank and clinical data from Health Data Compass (HDC). We evaluated 29 variants in 13 pharmacogenes and 42 Clinical Pharmacogenetics Implementation Consortium (CPIC) level A or B medications (i.e., sufficient evidence to recommend at least one prescribing action based on genetics). The primary outcome was actionable exposure to a PGx medication (i.e., actionable phenotype and a prescription for an affected PGx medication). Results: The study included 358 patients. All patients were prescribed at least one PGx medication, and 49.4% had at least one actionable exposure to a PGx medication during the first six months post-transplant. The frequency of actionable exposure was highest for tacrolimus (15.4%), followed by proton pump inhibitors (PPIs) (15.1%) and statins (12.8%). Statin actionable exposures significantly differed by transplant type, likely due to variations in prescribing patterns and actionable phenotypes for individual statins. Conclusions: Our findings highlight the potential clinical utility of PGx testing among SOT patients. Further studies are needed to address the impact on clinical outcomes and the optimal timing of PGx testing in the SOT population.

Keywords: biobank; pharmacogenetics; pharmacogenomics; solid organ transplant.

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Conflict of interest statement

K.M.D. was an employee of the University of Colorado at the time of this work and is currently an employee of Amgen Pharmaceuticals. All other authors report no conflicts of interest.

Figures

Figure 1
Figure 1
Number and percentage of solid organ transplant recipients in the Colorado Center for Personalized Medicine biobank (N = 358) with variant pharmacogenetic phenotypes.
Figure 2
Figure 2
Number and percentage of solid organ transplant recipients in the Colorado Center for Personalized Medicine biobank (N = 358) prescribed pharmacogenetic medications during the first 6 months post-transplant.
Figure 3
Figure 3
Among the 358 solid organ transplant recipients in the Colorado Center for Personalized Medicine biobank: (A) prevalence of actionable exposures to pharmacogenetic (PGx) medications with strong, moderate, or optional Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline recommendations during the first six months post-transplant; (B) prevalence of actionable exposures to PGx medications with strong or moderate CPIC guideline recommendations during the first six months post-transplant.
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