Many factors influence kidney transplant survival in Black organ recipients, including socioeconomics, genomics, and achieving regulatory immunosuppressive drug levels in the blood.
According to a new study led by Kathleen Tornatore, PharmD, professor of pharmacy practice at the University of Buffalo at Buffalo School of Pharmacy and Pharmaceutical Sciences, black kidney transplant recipients have a faster clearance of immunosuppressive drugs than their counterparts. with white people.
The study, published earlier this year in pharmaceutical therapy, was one of the first to study how both race and gender affect the pharmacokinetics of tacrolimus (the study of how the drug moves around the body).
Tacrolimus It is an important drug for the survival of a transplanted organ that suppresses the immune system, preventing white blood cells from attacking the transplanted organ. Most organ transplant recipients receive a combination of immunosuppressive drugs including tacrolimus and mycophenolic acid, Tornatore said.
To achieve the recommended in vivo concentrations of tacrolimus, clinicians often prescribe higher doses of the drug to black kidney transplant patients than to white patients.
Despite dose differences, the long-term effects of race combined with gender on individualized tacrolimus regimens in people of color and women, Tornatore said.
“These study findings may guide individualized approaches to long-term tacrolimus use that take into account both sex and race,” Tornatore said.
The study examined 65 stable kidney transplant recipients – including men and women, and blacks and whites – who received tacrolimus for more than six months after transplant surgery. Blacks received an almost 55% higher dose of tacrolimus after transplantation than whites. Black patients also exhibited a faster tacrolimus clearance rate, more than two-fold faster in black women.
Adverse events associated with tacrolimus were more pronounced in women taking the drug and were most prominent in Black women.
Future investigations will evaluate the immune response in kidney transplant recipients receiving long-term immunosuppressive drugs to prevent rejection and the effect of age on clearance rates of the drugs. this.