Do Sex and Ethnicity Influence Drug Pharmacokinetics in Solid Organ Transplantation

Abstract

A number of reports have identified differences in drug pharmacokinetics and pharmacodynamics between males and females, and between patients of different ethnicity. These differences are observed in both solid organ transplant recipients and in nontransplant patients. This review summarizes the pharmacokinetic differences thought to be dependent on sex and ethnicity noted with immunosuppressive agents commonly used in transplantation. This manuscript also touches on how these differences may translate into observed drug interactions. Furthermore, potential factors underlying the sex and ethnicity differences are evaluated. Current evidence points to differences in drug-metabolizing enzymes, transporters, cytokines, and environmental influences to account for the observed heterogeneity in drug response. Many of these factors seem to be under genetic control, and thus areas for further research are suggested.