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Tacrolimus (Tac) is mainly metabolized by cytochrome P450 3A isoenzymes. In a cohort of heart transplant recipients, we investigated the effect of CYP3A5, CYP3A4, and ABCB1/MDR1 polymorphisms on Tac dose requirements and the risk of developing new-onset diabetes after transplantation (NODAT).

A total of 65 heart transplant recipients were genotyped for 3 single nucleotide polymorphisms (SNPs) in the CYP3A5 (SNP rs776746), CYP3A4 (SNP rs2740574), and ABCB1 (SNP rs104564). The mean Tac dose values were compared between the genotypes.

CYP3A5*3 homozygotes (nonexpressers; n = 55, 85%) received significantly higher Tac dose compared with CYP3A5*1 carriers (expressers). No different NODAT frequencies were found between the genotypes.

The CYP3A5 polymorphism was the main determinant of Tac dose requirements …