Assessing the Utility of a Genotype‐Guided Tacrolimus Equation in African American Kidney Transplant Recipients: A Single Institution Retrospective Study

• DOI: 10.1002/jcph.2461
• Publication Date: 2024-05-20T08:09:20Z
• Authors: Joy E Obayemi; Lauren Callans; Nikhil Nair; Hui Gao; Divya Gandla; Bao‐Li Loza; Sarah Gao; Maedeh Mohebnasab; Jennifer Trofe‐Clark; Pamala Jacobson; Brendan Keating
• Keywords: Trough Concentration

Abstract Tacrolimus metabolism is heavily influenced by the CYP3A5 genotype, which varies widely among African Americans (AA). We aimed to assess performance of a published genotype‐informed tacrolimus dosing model in an independent set adult AA kidney transplant (KTx) recipients. genotypes were obtained for all KTx recipients (n = 232) from 2010 2019 who met inclusion criteria at single center Philadelphia, Pennsylvania, USA. Medical record data used calculate predicted clearance using equation and two modified iterations. Observed model‐predicted trough levels compared 3 days, months, 6 months post‐transplant. The mean prediction error day post‐transplant was 3.05 ng/mL, indicating that tended overpredict trough. This bias improved over time 1.36 0.78 ng/mL post‐transplant, respectively. Mean absolute error—a marker precision—improved with 2.33 months. Limiting genotype decreased precision. precision comparable studies previous cohorts. overprediction observed may represent overfitting initial cohort, possibly limiting generalizability.