What Is Known And Objective: Tacrolimus (TAC) is an immunosuppressant with large interpatient pharmacokinetic variability and a narrow therapeutic index. We report a case of acute cellular rejection (ACR) type IB with insufficient TAC blood concentrations (TAC C ).
Case Summary: ACR developed on the eighth postoperative day of kidney transplantation. During this period, TAC C were insufficient. This referred pharmacogenetic assessment disclosed the patient as a CYP3A5 expresser and CYP3A4*1B carrier. According to the genotype, higher doses of TAC, 15 mg twice daily, were administered and targeted TAC C were achieved.
What Is New And Conclusion: Our case presents an association of TAC rapid clearance and two alleles modifying greater CYP3A enzyme activity.
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