关键词:

肾移植 , 他克莫司 , 神经毒性反应 , 基因多态性

Abstract:

Objective Summarize the correlation between the detection of CYP3A5 polymorphism and tacrolimus neurotoxicity after renal transplantation. Methods A total number of 116 patients who received tacrolimus after renal transplantation in our hospital from 2017 to 2020 were analyzed retrospectively. Direct DNA sequencing was used to detect CYP3A5 polymorphism, and tacrolimus concentrations and neurotoxicity were observed in patients with different genes at different time points after surgery. Results The incidence of neurotoxicity inpatients receiving tacrolimus after renal transplantation was 38% , and in 116 renal transplant patients,the plasma concentrations of tacrolimus in patients with CYP3A5 * 3/* 3 genotype were lower than those with CYP3A5 * 1/* 1 and CYP3A5 * 1/* 3 genotypes within 2 weeks postoperatively, but higher than those with CYP3A5 * 1/* 1 and CYP3A5 * 1/* 3 genotypes at 2 weeks postoperatively and in the long term, there’s also a higher chance of neurotoxicity. Conclusion The concentration of tacrolimus in blood is an important factor of early neurological complications after renal transplantation. Patients with the CYP3A5 * 3/* 3 genotype were metabolizing slowly and had a higher probability of neurotoxicity. Blood concentrations of tacrolimus in patients with the CYP3A5 * 3/* 3 genotype were higher than the patients with other two genotypes with the same dose at two weeks after transplant, and the required dose should be reduced. 

Key words:

Kidney transplantation, Tacrolimus, Neurotoxicity, Polymorphism