title: Genes and beans: pharmacogenomics of renal transplant.
abstract: Advances in the management of patients after solid organ transplantation have led to dramatic decreases in rates of acute rejection, but long-term graft and patient survival have remained unchanged. Individualized therapy after transplant will ideally provide adequate immunosuppression while limiting the adverse effects of drug therapy that significantly impact graft survival. Therapeutic drug monitoring represents the best approximation of individualized drug therapy in transplant at this time; however, obtaining pharmacogenomic data in transplant patients has the potential to enhance our current practice. Polymorphisms of target genes that impact pharmacokinetics have been identified for most immunosuppressants, including tacrolimus, cyclosporine, mycophenolate, azathioprine and sirolimus. In the future, pre-emptive assessment of a patient's genetic profile may inform drug selection and provide information on specific doses that will improve efficacy and limit toxicity.
authors: Critical Care Clinical Specialist, UNC Hospitals & Clinics, 101 Manning Drive, CB #7600, Chapel Hill, NC 27599-7600, USA. bmurray@unch.unc.edu
authors: Brian
authors: B
authors: Murray
authors: Emily
authors: E
authors: Hawes
authors: Ruth-Ann
authors: RA
authors: Lee
authors: Robert
authors: R
authors: Watson
authors: Mary W
authors: MW
authors: Roederer
mesh_terms: D016903:Drug Monitoring / Q000379:methods; D006084:Graft Rejection / Q000235:genetics* / Q000517:prevention & control*; D006085:Graft Survival / Q000235:genetics*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D010597:Pharmacogenetics / Q000379:methods*; D011110:Polymorphism, Genetic / Q000235:genetics
chemical_list: D007166:Immunosuppressive Agents