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Do Sex and Ethnicity Influence Drug Pharmacokinetics in Solid Organ Transplantation?

Gary S. Friedman

Gregory T. Knipp

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

Key Words: Pharmacokinetics • drug interactions • ethnicity • immunosuppressives

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