Publication Name	World Journal of Transplantation
Manuscript ID	107636
Country	India

Category	Transplantation
Manuscript Type	Retrospective Study
Article Title	Impact of cytochrome P450 3A5 expression on clinical outcomes in renal transplant recipients receiving tacrolimus-based immunosuppression
Manuscript Source	Invited Manuscript
All Author List	Amit S Pasari, Sunny Malde, Priyanka Tolani, Vishal Ramteke, Sushrut Gupta, Twinkle Pawar, Vijay Jeyachandran, Kapil Sejpal, Mohit Kurundwadkar, Prasad Gurjar, Pranjal Kashiv, Shubham Dubey, Charulata Bawankule, Vivek B Kute, Nishant Deshpande and Manish Ramesh Balwani
Funding Agency and Grant Number
Corresponding Author	Vishal Ramteke, MD, Department of Nephrology, Max Super Speciality Hospital, 232 Mankapur Koradi Road, Nagpur 440030, Mahārāshtra, India. vvramteke@gmail.com
Key Words	Cytochrome P450 3A5 expression; Polymorphism; Renal transplant; Tacrolimus; Tacrolimus trough concentration (ng/mL)/daily tacrolimus dose (mg/kg/day) ratio
Core Tip	This study evaluated the effect of cytochrome P450 3A (CYP3A) 5 polymorphism on tacrolimus pharmacokinetics and clinical outcomes in renal transplant recipients. CYP3A5 expressors required significantly higher tacrolimus doses than non-expressors from 6 months onward to maintain therapeutic levels. Non-expressors consistently showed higher tacrolimus trough concentration (ng/mL)/daily tacrolimus dose (mg/kg/day) ratios, reflecting slower drug metabolism. Despite these differences, no significant impact was seen on acute rejection rates, renal function, or complications such as new onset diabetes after transplantation and hypomagnesemia. These findings emphasize the importance of genotype-guided tacrolimus dosing for individualized immunosuppressive management, while therapeutic drug monitoring helps mitigate clinical variability, ensuring comparable outcomes between expressors and non-expressors.
Citation	Pasari AS, Malde S, Tolani P, Ramteke V, Gupta S, Pawar T, Jeyachandran V, Sejpal K, Kurundwadkar M, Gurjar P, Kashiv P, Dubey S, Bawankule C, Kute VB, Deshpande N, Balwani MR. Impact of cytochrome P450 3A5 expression on clinical outcomes in renal transplant recipients receiving tacrolimus-based immunosuppression. World J Transplant 2025; In press

Received	2025-03-28 04:08
Peer-Review Started	2025-03-28 04:09
To Make the First Decision
Return for Revision	2025-04-14 04:17
Revised	2025-04-20 16:23
Second Decision	2025-06-04 02:38
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-06-04 09:58
Articles in Press	2025-06-04 09:58
Publication Fee Transferred
Edit the Manuscript by Language Editor	2025-06-05 07:43
Typeset the Manuscript

ISSN	2220-3230 (online)
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