DCD供体CYP3A5基因型分析法在肝移植术后应用的初步研究
首发时间:2013-04-22
摘要:目的 研究心脏死亡捐献供体基因型分析法对受体FK506的初始剂量指导意义,为肝移植FK506的早期使用提供个体化方案。方法 选择2010年3月-2013年3月心脏死亡捐献肝移植且CYP3A5基因型与供体不相同的受体36例,随机均分成实验组与对照组,实验组根据供体CYP3A5基因型不同调整术后FK506的初始剂量。对照组按照传统方法根据经验给药。结果 实验组术后7天平均血药浓度为(7.47±1.83) ng/mL,达目标血药浓度范围占72.2%。对照组肝移植术后第7天平均血药浓度为(8.68±5.14) ng/ml,达目标血药浓度范围占38.9%。实验组需要调整FK506剂量的占22.2%,而对照组占55.6%。两组术后7天目标浓度范围、需要调整剂量的百分比有统计学差异(P=0.044,P=0.040)。结论 根据DCD供体CYP3A5基因型不同,可以科学调整FK506初始剂量。使移植患者术后尽早达到目标血药浓度,减少排斥反应发生率,降低药物毒副作用,实现FK506个体化用药。
关键词: 肝移植 心脏死亡供体 CYP3A5基因 个体化用药
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The preliminary study on the application of DCD donor CYP3A5 genotype analysis in liver transplantation
Abstract:Objective To investigate the effect of the genotypic analysis of donor from cardiac death donation on the initial dose of FK506 for liver transplant recipients and provide liver transplantation patients with individualized administration for the early use of FK506. Method 36 recipients with a different genotype of CYP3A5 from cardiac death donors' were collected from March 2010 to February 2013. The matched recipients were randomly divided into experiment group and control group. There was an adjustment of initial doses of FK506 according to the donors' different CYP3A5 genotypes in experiment group but the control group not. Results For experiment and control group, the average FK506 blood concentrations in the 7th days after operation were (7.47±1.83) ng/mL and (8.68±5.14) ng/ml and the percent of reached optimal FK506 concentrations were 72.2% and 38.9%. Furthermore, 22.2% and 55.6% recipients needed adjustments of FK506 concentrations. There were significant differences between two groups in the 7th FK506 blood concentrations and the percentage of needing adjustment (P=0.044,P=0.040). Conclusion individualized adjustment FK506 initial doses of recipients according to cardiac death donors' different CYP3A5 genotypes was benefit for reaching optimal concentrations as soon as possible and could decrease the rate of rejection, reduce the side effects.
Keywords: cardiac death donors CYP3A5 gene liver transplantation individualized medication
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