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KMID : 0370220180620050334
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Yakhak Hoeji
2018 Volume.62 No. 5 p.334 ~ p.344
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The Effect of ABCB1 C3435T on Blood trough Concentrations of Tacrolimus in Renal Transplant Recipients: a Systematic Review and Meta-analysis
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Sin Hye-Yeon
Chun Pu-Soon
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Abstract
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A large number of studies have investigated the influence of ABCB1 C3435T polymorphism on blood trough concentrations of tacrolimus in kidney transplant recipients. However, the results are inconsistent. The aim of the present study was to clarify the effects of ABCB1 C3435T on trough blood levels of tacrolimus in renal transplant recipients at different post-transplantation times. The databases of PubMed, Embase, Ovid, and Cochrane Library were searched for all published studies from inception to March 2018. In addition, reference lists of articles were also examined. Using the Review Manager 5, weighted mean differences of dose-adjusted trough concentration of tacrolimus were pooled to estimate the effects of ABCB1 C3435T on tacrolimus levels. A total of 11 studies (968 recipients) were included in the present meta-analysis. The adult recipients with CC genotype had lower dose-adjusted trough concentration of tacrolimus than the CT and TT carriers at the first week after kidney transplantation (CC vs CT, WMD: -14.82; 95% CI: -24.73, -4.90; p=0.003; CC vs TT, WMD: -30.73; 95% CI: -47.9, -13.57; p=0.0004). Similar results were observed in adult recipients at the first month after transplantation (CC vs CT, WMD: -19.61; 95% CI: -27.66, -11.56; p＜0.00001; CC vs TT, WMD: -25.45; 95% CI: -47.68, -3.22; p=0.02). Furthermore, at 3 months, the pediatric and adult recipients with CC or CT genotype had lower dose-adjusted trough concentration than the TT carriers (CT vs TT, WMD: -11.85; 95% CI: -18.65, -5.04; p=0.0006; CC vs TT, WMD: -30.98; 95% CI: -37.46, -24.50; p＜0.00001). In addition, at the time of 6 months, the adult recipients carrying 3435C allele had lower dose-adjusted trough concentration than the TT carriers (CC vs CT, WMD: -19.00; 95% CI: -23.60, -14.39; p＜0.00001; CT vs TT, WMD: -6.57; 95% CI: -12.87, -0.28; p=0.04; CC vs TT, WMD: -26.46; 95% CI: -32.04, -20.88; p＜0.00001). These results imply that the adult recipients carrying ABCB1 3435C allele need higher dose of tacrolimus to prevent acute rejection after kidney transplantation.
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KEYWORD
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ABCB1 C3435T polymorphism, blood trough concentration, tacrolimus, kidney transplant recipients
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