Centre for Clinical Pharmacology, Military Medical Academy Medical Faculty, University of Defence , Belgrade , Serbia.
Solid Organ Transplantation Center, Military Medical Academy , Belgrade , Serbia.
Front Public Health. 2016 Aug 31;4:189. doi: 10.3389/fpubh.2016.00189. eCollection 2016.
Renal transplantation is the treatment of choice for the patients with end-stage renal failure. Genetic factors, among others, can influence variability in response to immunosuppressive drugs. Nowadays, due to restrictive health resources, the question arises whether routine pharmacogenetic analyses should be done in the renal transplant recipients or not. The aim of this literature review was to present the up-to-date information considering the economic feasibility of pharmacogenetic testing in patients subjected to renal transplantation. The organization United Network for Organ Sharing in the US estimated that total costs per renal transplant concerning these analyses were $334,300 in 2014. Pharmacogenetic testing prior to treatment initiation could be helpful to predict and assess treatment response and the risks for adverse drug reactions. This kind of testing before treatment initiation seems to be one of the most promising applications of pharmacokinetics. Although pharmacogenetic tests were found to be a cost-effective or cost-saving strategy in many cases, some authors represent another opinion. However, if the real costs of renal transplantation are recognized, the application of these tests in the standard daily practice could be considered more realistic, which additionally emphasizes the importance of future studies assessing their cost effectiveness.
肾移植是治疗终末期肾衰竭患者的首选方法。遗传因素等因素会影响免疫抑制剂药物反应的变异性。如今，由于医疗资源有限，出现了一个问题，即是否应该对接受肾移植的患者进行常规的药物遗传学分析。本文献综述的目的是介绍考虑到药物遗传学检测在肾移植患者中的经济可行性的最新信息。美国联合器官共享网络估计，2014 年这些分析的每个肾移植总费用为 334300 美元。在治疗开始前进行药物遗传学检测有助于预测和评估治疗反应以及药物不良反应的风险。这种在治疗开始前进行的检测似乎是药代动力学最有前途的应用之一。尽管在许多情况下，药物遗传学检测被发现是一种具有成本效益或节省成本的策略，但也有一些作者持不同意见。然而，如果认识到肾移植的实际成本，那么在标准日常实践中应用这些检测可能会被认为更加现实，这进一步强调了未来评估其成本效益的研究的重要性。
