The effect of CYP3A5 6986A>G and ABCB1 3435C>T on tacrolimus dose-adjusted trough levels and acute rejection rates in renal transplant patients: A systematic review and meta-analysis

摘要

In the present study, we performed a systematic review and meta-analysis on published data to examine the impact of CYP3A5 6986AG and ABCB1 3435CT polymorphisms on tacrolimus dose-adjusted trough levels (C 0/D) and acute rejection rates in adult renal transplant patients. Despite the presence of significant heterogeneity in all comparisons, random-effects model showed significantly higher tacrolimus C 0/D in CYP3A5*3/*3 compared with CYP3A5* 1 allele carriers, either in the overall analysis and when stratifying for ethnicity or time of post-transplantation (≤1, 3-6, 12-24 months). In contrast, no consistent evidence of an effect of the ABCB1 3435CT variant was detected on tacrolimus C 0/D, except for a modest effect limited to the first month after renal transplantation. In addition, from the current evidence available, CYP3A5 6986AG and ABCB1 3435CT polymorphisms seem to have little or no effect on the acute rejection rates in renal transplant patients under immunosuppressive therapy with tacrolimus.