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Focused pharmacogenomic panel for transplanted patients


Untreated chronic hepatitis can progress to cirrhosis with consequent loss of function and onset of complications. In the final stage of the disease, the only treatment is liver transplantation. Liver transplantation has improved patient survival, however, the use of immunosuppressants required to obtain the best results with transplantation is not free of complications and challenges such as rejection, infections and morbidities such as hypertension, diabetes mellitus and loss of renal function. In a recent study in our Department of cirrhotic patients with transplanted hepatitis C virus, 11.4% of the patients had episodes of rejection and 36.3% had infections within the first 30 days after hepatic transplantation [1]. Differences in therapeutic responses with the use of immunosuppressants and anti-infectives among individuals are generally associated with genetic polymorphisms present in genes that affect pharmacokinetics or pharmacodynamics [2]. The polymorphisms that present the greatest potential for use in a drug selection algorithm are the CYP3A5, ABCB1, IMPDH1 and IMPDH2 genes and cytokines and growth factors. The objective of this study was to verify the frequency of polymorphisms of the genes responsible for the absorption, distribution, metabolism and excretion (ADME) of drugs used for liver transplant patients in the Department of Gastroenterology, Hospital das Clínicas, Medical School, USP (HC-FMUSP). Forty-eight transplanted patients and their respective organs will be studied, and it is expected to correlate the polymorphisms with the frequency of rejection and occurrence of infections after liver transplantation. (AU)

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