ExTHIRUVANANTHAPURAM: TWO scientists with the Rajiv Gandhi Centre for Biotechnology (RGCB) have developed a method to increase the success of kidney transplantation specifically among patients from Kerala. The genetic study determines the optimal dose of immunosuppressant drug to be administered to prevent organ rejection, a major risk factor in transplantation procedures.
Radhakrishnan Nair and Lekshmy Srinivas, Division of Laboratory Medicine and Molecular Diagnostics, RGCB, conducted the pharmacogenetic study involving patients who have undergone kidney transplantation at the Thiruvananthapuram Government Medical College Hospital.
At present, the dose of the drug administered to patients to lower the body’s immunity is calculated on the basis of body weight. In this procedure, blood levels have to be closely monitored and doses adjusted, as lower levels can lead to rejection of the transplanted kidney, while higher levels can cause medical complications. Not only is this trial-and-error method time-consuming and costly, but it also creates other complications for the patient.
“Though similar studies have been conducted among other populations before, the predictive value of pharmacogenetic factors identified were insufficient and not enough for clinical use. The new development would help prevent the adverse effects of overdose and help a lot of patients,” said Chandrabhas Narayana, director, RGCB.
The researchers studied the effect of genes and their variants in determining the drug concentration in a patient’s blood. “We have developed an equation/technique that can be used by nephrologists to predict the starting dose of the immunosuppressant drug tacrolimus, which has to be administered to patients to attain optimal drug level in the initial period after the surgery, based on their genetic profiles,” Radhakrishnan Nair said.
“This equation is specific to patients from Kerala who undergo kidney transplantation. The molecular-based method tests the patient’s DNA for a specific variation before the surgery,” Dr Lekshmy Srinivas explained.
The dose prediction study was focused on tacrolimus, which is administered to kidney, heart or liver transplant patients. The pioneering study was conducted in collaboration with Dr Noble Gracious, Department of Nephrology, Government Medical College Hospital, Thiruvananthapuram. The group has also discovered the genetic variants that increase the chances of rejection and the adverse effects associated with the drug.
The research, which has significant potential to save lives of kidney transplant patients, was jointly funded by the Science and Engineering Research Board and the RGCB, and was published in the journal Frontiers in Pharmacology.