Effect of Schisandra Sphenanthera Extract on Pharmacokinetics of Tacrolimus in Pediatric Renal Transplant Recipients
1Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China, 2The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Meeting: 2022 American Transplant Congress
Abstract number: 833
Keywords: FK506, Kidney transplantation, Pediatric, Pharmacokinetics
Topic: Clinical Science » Kidney » 43 - Kidney: Pediatrics
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: Wuzhi tablet (Schisandra sphenanthera extract) is a promising tacrolimus-sparing agent in adult renal transplant recipients, while its effect in pediatric recipients remains unclear. The aim of this study was to investigate the effect of Wuzhi tablet on pharmacokinetics of tacrolimus (FK506) and clinical outcome in pediatric renal transplant patients.
*Methods: We conducted a two-part retrospective study of pediatric renal transplant patients treated with FK506 from July 2015 to May 2020. Clinical data of FK506 dose, FK506 trough level, acute rejection, renal function, infection, hepatic enzymes and hemoglobin, etc were collected.
*Results: In the self-control study (Part I), fifty-five pediatric renal transplant patients were enrolled. Lower FK506 dose whereas higher FK506 trough level at day 7, day 14, day 90 (P < 0.001) correlated with Wuzhi tablet. After co-administration of Wuzhi tablet, the average individual increment (%) in dose-adjusted C0 of tacrolimus in day 7, day 14 and day 90 were 117.56 %, 118.56 % and 146.47%, respectively (P < 0.001), while the average individual reduction (%) in tacrolimus daily dose were 2.22 %, 18.57 % and 44.19% (P < 0.001). The daily dose of Wuzhi tablet, hemoglobin level and the period of Wuzhi tablet co-administration influenced FK506 trough level. In the case-control study (Part II), a total of 66 pediatric renal transplant patients were divided into the Wuzhi tablet group (n=33) and the control group (n=33). Compared with the control group, the average individual reduction in tacrolimus daily dose and the average individual increment in dose-adjusted C0 of tacrolimus were higher in Wuzhi tablet group in the early postoperative period (P<0.05). Although there were more patients who were high-dose tacrolimus consumers (CYP3A5*1 allele carriers, CYP3A5 expressers) in Wuzhi tablet group (P<0.01), there were no statistically significant differences in adjusted FK506 dose and dose-adjusted C0 of tacrolimus in two groups.
*Conclusions: Wuzhi tablet increases bioavailability of tacrolimus, which may be a useful tacrolimus-sparing agent in pediatric renal transplant recipients.
To cite this abstract in AMA style:
Jiang J, Zhang H, Su X, Wu S, Chen Y, Chen W, Li J, Wu C, Yang L, Liu L, Wang C. Effect of Schisandra Sphenanthera Extract on Pharmacokinetics of Tacrolimus in Pediatric Renal Transplant Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-schisandra-sphenanthera-extract-on-pharmacokinetics-of-tacrolimus-in-pediatric-renal-transplant-recipients/. Accessed May 17, 2025.« Back to 2022 American Transplant Congress