Precision Medicine for Tacrolimus Dosing in Heart Transplant Recipients

Abstract

Interpatient variability in tacrolimus requirements are large and influenced by multiple factors including cytochrome P450 (CYP) genetics, specifically by CYP3A5 and to a lesser extent CYP3A4. Tacrolimus dosing tailored to CYP genotype has been shown to shorten time to therapeutic range in kidney transplant but data in heart transplant recipients is sparse and findings are variable. We recently implemented weight and genotype-based initial tacrolimus dosing in our heart transplant program. The objective of this study is to examine the impact of genetically tailored tacrolimus dosing on achieving therapeutic trough levels.