Pharmacogenomics testing in patients with liver transplant and potential impact on prospective management

Jessica A. Wright; Ann M. Moyer; Joseph Sutton; Amanda J. Chaney; Wayne T. Nicholson; Razan M. El Melik; Eric T. Matey; Suzette J. Bielinski; Kristin Mara; John Logan Black; Pedro J. Caraballo

doi:10.2217/pgs-2021-0076

Pharmacogenomics testing in patients with liver transplant and potential impact on prospective management

Jessica A. Wright, Ann M. Moyer, Joseph Sutton, Amanda J. Chaney, Wayne T. Nicholson, Razan M. El Melik, Eric T. Matey, Suzette J. Bielinski, Kristin Mara, John Logan Black, Pedro J. Caraballo

Research output: Contribution to journal › Article › peer-review

Abstract

Aim: Pharmacogenomics (PGx) tests are performed on whole-blood or saliva specimens. In patients with a transplanted liver, PGx results may be discordant with hepatic drug metabolizing enzyme activity. We evaluate the incidence and impact of PGx testing in liver transplant recipients, detail potential errors and describe clinical decision support (CDS) solution implemented. Materials & methods: A retrospective cohort study of liver transplant recipients at Mayo Clinic who underwent PGx testing between 1 January 1996 and 7 October 2019 were characterized. Impact of a CDS solution was evaluated. Results: There were 129 PGx tests in 117 patients. PGx testing incidence increased before (per year incidence rate ratio = 1.45, 95% CI: 1.20-1.74, p < 0.001) and after transplant (incidence rate ratio = 1.48, 95% CI: 1.27-1.72, p < 0.001). Three erroneous PGx tests were avoided 6 months following CDS implementation. Conclusion: Incidence of PGx testing in liver transplant recipients is increasing, leading to erroneous therapeutic decisions. CDS interventions and education are needed to prevent errors.

Original language	English (US)
Pages (from-to)	1177-1183
Number of pages	7
Journal	Pharmacogenomics
Volume	22
Issue number	18
DOIs	https://doi.org/10.2217/pgs-2021-0076
State	Published - Dec 2021

Keywords

health records
liver
pharmacogenetics
pharmacogenomics
transplantation

ASJC Scopus subject areas

Molecular Medicine
Genetics
Pharmacology

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10.2217/pgs-2021-0076

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@article{44462dea0c20415aa2ca2b89ece1e25a,

title = "Pharmacogenomics testing in patients with liver transplant and potential impact on prospective management",

abstract = "Aim: Pharmacogenomics (PGx) tests are performed on whole-blood or saliva specimens. In patients with a transplanted liver, PGx results may be discordant with hepatic drug metabolizing enzyme activity. We evaluate the incidence and impact of PGx testing in liver transplant recipients, detail potential errors and describe clinical decision support (CDS) solution implemented. Materials & methods: A retrospective cohort study of liver transplant recipients at Mayo Clinic who underwent PGx testing between 1 January 1996 and 7 October 2019 were characterized. Impact of a CDS solution was evaluated. Results: There were 129 PGx tests in 117 patients. PGx testing incidence increased before (per year incidence rate ratio = 1.45, 95% CI: 1.20-1.74, p < 0.001) and after transplant (incidence rate ratio = 1.48, 95% CI: 1.27-1.72, p < 0.001). Three erroneous PGx tests were avoided 6 months following CDS implementation. Conclusion: Incidence of PGx testing in liver transplant recipients is increasing, leading to erroneous therapeutic decisions. CDS interventions and education are needed to prevent errors.",

keywords = "health records, liver, pharmacogenetics, pharmacogenomics, transplantation",

author = "Wright, {Jessica A.} and Moyer, {Ann M.} and Joseph Sutton and Chaney, {Amanda J.} and Nicholson, {Wayne T.} and {El Melik}, {Razan M.} and Matey, {Eric T.} and Bielinski, {Suzette J.} and Kristin Mara and Black, {John Logan} and Caraballo, {Pedro J.}",

note = "Publisher Copyright: {\textcopyright} 2021 Future Medicine Ltd.",

year = "2021",

month = dec,

doi = "10.2217/pgs-2021-0076",

language = "English (US)",

volume = "22",

pages = "1177--1183",

journal = "Pharmacogenomics",

issn = "1462-2416",

publisher = "Future Medicine Ltd.",

number = "18",

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TY - JOUR

T1 - Pharmacogenomics testing in patients with liver transplant and potential impact on prospective management

AU - Wright, Jessica A.

AU - Moyer, Ann M.

AU - Sutton, Joseph

AU - Chaney, Amanda J.

AU - Nicholson, Wayne T.

AU - El Melik, Razan M.

AU - Matey, Eric T.

AU - Bielinski, Suzette J.

AU - Mara, Kristin

AU - Black, John Logan

AU - Caraballo, Pedro J.

PY - 2021/12

Y1 - 2021/12

N2 - Aim: Pharmacogenomics (PGx) tests are performed on whole-blood or saliva specimens. In patients with a transplanted liver, PGx results may be discordant with hepatic drug metabolizing enzyme activity. We evaluate the incidence and impact of PGx testing in liver transplant recipients, detail potential errors and describe clinical decision support (CDS) solution implemented. Materials & methods: A retrospective cohort study of liver transplant recipients at Mayo Clinic who underwent PGx testing between 1 January 1996 and 7 October 2019 were characterized. Impact of a CDS solution was evaluated. Results: There were 129 PGx tests in 117 patients. PGx testing incidence increased before (per year incidence rate ratio = 1.45, 95% CI: 1.20-1.74, p < 0.001) and after transplant (incidence rate ratio = 1.48, 95% CI: 1.27-1.72, p < 0.001). Three erroneous PGx tests were avoided 6 months following CDS implementation. Conclusion: Incidence of PGx testing in liver transplant recipients is increasing, leading to erroneous therapeutic decisions. CDS interventions and education are needed to prevent errors.

AB - Aim: Pharmacogenomics (PGx) tests are performed on whole-blood or saliva specimens. In patients with a transplanted liver, PGx results may be discordant with hepatic drug metabolizing enzyme activity. We evaluate the incidence and impact of PGx testing in liver transplant recipients, detail potential errors and describe clinical decision support (CDS) solution implemented. Materials & methods: A retrospective cohort study of liver transplant recipients at Mayo Clinic who underwent PGx testing between 1 January 1996 and 7 October 2019 were characterized. Impact of a CDS solution was evaluated. Results: There were 129 PGx tests in 117 patients. PGx testing incidence increased before (per year incidence rate ratio = 1.45, 95% CI: 1.20-1.74, p < 0.001) and after transplant (incidence rate ratio = 1.48, 95% CI: 1.27-1.72, p < 0.001). Three erroneous PGx tests were avoided 6 months following CDS implementation. Conclusion: Incidence of PGx testing in liver transplant recipients is increasing, leading to erroneous therapeutic decisions. CDS interventions and education are needed to prevent errors.

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KW - liver

KW - pharmacogenetics

KW - pharmacogenomics

KW - transplantation

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Pharmacogenomics testing in patients with liver transplant and potential impact on prospective management

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